NPIMap

Individual provider Active NPI

Athan Georgiades, M.D.

  • Surgery Physician
  • Monroeville, PA
National Provider Identifier
1972518363
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD039189L Issued in PA
Practice address
4318 Northern Pike
Suite 101
Monroeville, PA 15146-2809
Phone
(412) 683-2267
Fax
(412) 683-3422
NPI assigned
Jul 31, 2006
Last updated
Jun 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD039189L PA Primary

Addresses

Primary practice location

4318 Northern Pike
Suite 101
Monroeville, PA 15146-2809

Mailing address

4318 Northern Pike
Suite 101
Monroeville, PA 15146-2809
Phone (412) 683-2267

Other identifiers 1

IdentifierTypeStateIssuer
020054678OtherPARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110301000366 PA Practitioner - General SurgeryPractitioner - Surgical Oncology 8325229081 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Surgical Oncology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgiades Surgical AssociatesGroup PAC ID 7911956164, 2 clinicians

Practice addresses (Care Compare)

4318 Northern Pike
Suite 101
Monroeville, PA 15146-2823
Phone (412) 683-2267

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Mastectomy1-10
Removal of tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD039189LPAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DV Professional Group PLLC CurrentSince Jul 1, 2024 Accepting new patients
Georgiades Surgical Associates Surgery CurrentSince Feb 1, 2003 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

4318 Northern Pike
Ste 101
Monroeville, PA 15146
Phone (412) 212-0123

5200 Centre Ave
Ste 614
Pittsburgh, PA 15232
Phone (412) 683-2267

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1972518363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4318 NORTHERN PIKE",
            "address_2": "SUITE 101",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462809",
            "telephone_number": "412-683-2267",
            "fax_number": "412-683-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 NORTHERN PIKE",
            "address_2": "SUITE 101",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462809",
            "telephone_number": "412-683-2267",
            "fax_number": "412-683-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGIADES",
        "first_name": "ATHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD039189L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020054678",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

Verify at the official NPI Registry.