NPIMap

Organization Active NPI

Squirrel Hill Health Center

  • Federally Qualified Health Center (FQHC)
  • Pittsburgh, PA
National Provider Identifier
1982658308
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
N/A Issued in NU
Legal business name
SQUIRREL HILL HEALTH CENTER
Practice address
4516 Browns Hill Rd
Pittsburgh, PA 15217-2917
Phone
(412) 422-7442
Fax
(412) 904-5025
NPI assigned
May 20, 2006
Last updated
Feb 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Authorized official

Name
Susan Freidberg Kalson
Title
Ceo
Phone
(412) 422-7442

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X N/A NU Primary

Addresses

Primary practice location

4516 Browns Hill Rd
Pittsburgh, PA 15217-2917

Mailing address

4516 Browns Hill Rd
Pittsburgh, PA 15217-2917
Phone (412) 422-7442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060523000038 PA Part A Provider - Federally Qualified Health Center (FQHC) 2567473937 Practice locations: Pittsburgh, PA
O20070104000314 PA Part B Supplier - Clinic/Group Practice 2567473937 Receives reassigned benefits from 34 practitioners
Practice locations: Brentwood, PA; Pittsburgh, PA; Turtle Creek, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982658308. Details of each certification follow.

Federally qualified health center certification: CCN 391957

Legal name
SQUIRREL HILL HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 24, 2006
Last certification
May 24, 2006
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 18, 2003 in PA
Enrollment address
4516 Browns Hill Rd
Pittsburgh, PA 15217-2917

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

103 Towne Square Way
Pittsburgh, PA 15227
Phone (412) 422-7442

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ganga Baral Individual Corporate Director Sep 1, 2018
Elizabeth Hazlett Individual Corporate Director Sep 1, 2018
Amy Cohn Individual Corporate OfficerCfo Nov 8, 2021 50%
W-2 Managing EmployeeCfo Nov 8, 2021 50%
Kevin Bolding Individual Corporate Director Sep 1, 2017
Margaret Petruska Individual Corporate Director Sep 1, 2016
Thomas Albanesi Individual Corporate DirectorBoard Treasurer Sep 1, 2016
Susan Kalson Individual Corporate OfficerChief Executive Officer Jun 20, 2006 100%
W-2 Managing EmployeeChief Executive Officer Jun 20, 2006 100%
Pat Siger Individual Corporate Director Sep 1, 2016

Practitioners & affiliated clinicians

Practitioners 34

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.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676592000000",
    "number": "1982658308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4516 BROWNS HILL RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152172917",
            "telephone_number": "412-422-7442",
            "fax_number": "412-904-5025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4516 BROWNS HILL RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152172917",
            "telephone_number": "412-422-7442",
            "fax_number": "412-904-5025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SQUIRREL HILL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A",
        "authorized_official_last_name": "FREIDBERG KALSON",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "412-422-7442"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.