NPIMap

Organization Active NPI

Preferred Primary Care Physicians

Doing business as PPCP McClellandtown Road Iannamorelli

  • Specialist
  • Uniontown, PA
National Provider Identifier
1962554642
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PREFERRED PRIMARY CARE PHYSICIANS
Doing business as
PPCP McClellandtown Road Iannamorelli
Practice address
104 McClellandtown Rd
Suite B
Uniontown, PA 15401-5527
Phone
(724) 438-1808
NPI assigned
Jan 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Lutz
Title
Executive Director
Phone
(412) 531-2902

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

104 McClellandtown Rd
Suite B
Uniontown, PA 15401-5527

Mailing address

104 McClellandtown Rd
Suite B
Uniontown, PA 15401-5527
Phone (724) 438-1808

Other identifiers 1

IdentifierTypeStateIssuer
0010198580007MedicaidPA

Other names 1

  • PPCP McClellandtown Road Iannamorelli Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040102000049 PA Part B Supplier - Clinic/Group Practice 8527967256 Receives reassigned benefits from 120 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pittsburgh, PA; Presto, PA; Uniontown, PA; Washington, PA; MC Murray, PA; Carnegie, PA; Munhall, PA; Bethel Park, PA…

Other NPIs on the same Medicare enrollment 22

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 22

National Provider Directory

National Provider Directory

Locations

1263 State Route 40 W
Claysville, PA 15323
Phone (724) 663-7731

104 McClellandtown Rd
Ste B
Uniontown, PA 15401
Phone (724) 438-1808

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962554642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 MCCLELLANDTOWN RD",
            "address_2": "SUITE B",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154015527",
            "telephone_number": "724-438-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MCCLELLANDTOWN RD",
            "address_2": "SUITE B",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154015527",
            "telephone_number": "724-438-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED PRIMARY CARE PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUTZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "412-531-2902"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010198580007",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PPCP McClellandtown Road Iannamorelli",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Uniontown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.