1932170115 NPI number — DR. ROSS F DIMARCO JR. M.D.

Table of content: DR. ROSS F DIMARCO JR. M.D. (NPI 1932170115)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932170115 NPI number — DR. ROSS F DIMARCO JR. M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DIMARCO
Provider First Name:
ROSS
Provider Middle Name:
F
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932170115
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
127 ONEIDA VALLEY RD STE 201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BUTLER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16001-2239
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-431-4328
Provider Business Mailing Address Fax Number:
724-431-2288

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1050 BOWER HILL RD STE 203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15243-1868
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-444-0098
Provider Business Practice Location Address Fax Number:
412-444-0111
Provider Enumeration Date:
01/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208G00000X , with the licence number:  MD-015833E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 77785 . This is a "US HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0611207 . This is a "MEDICAID" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0611207 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1003920 . This is a "GATEWAY HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 100777 . This is a "UPMC HEALTH PLANS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 060008937 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 171016101 . This is a "BEST HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 66164 . This is a "THREE RIVERS HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 060008973 . This is a "PHCS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: C30272 . This is a "HEALTH AMERICA/ASSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0006946540002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0006946540004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 171016101 . This is a "INTERGROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 106193 . This is a "HIGHMARK/KEYSTONE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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