1164426896 NPI number — UPMC CHILDREN'S HOSPITAL OF PITTSBURGH

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164426896 NPI number — UPMC CHILDREN'S HOSPITAL OF PITTSBURGH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UPMC CHILDREN'S HOSPITAL OF PITTSBURGH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1164426896
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 GRANT STREET, US STEEL TOWER, 59TH FLOOR
Provider Second Line Business Mailing Address:
C/O RENEE JOHNSON
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15219-2740
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-623-6303
Provider Business Mailing Address Fax Number:
412-623-6369

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4401 PENN AVE
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:
15224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-432-7469
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
WILFONG
Authorized Official First Name:
MARIO
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
412-692-5013

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282NC2000X , with the licence number: 291201 , 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: 39330202 . This is a "HEALTHAMERICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0029 . This is a "HIGHMARK BLUE CROSS BLUE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00311869X , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 092432600 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 22 . This is a "UPMC COMMERCIAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0010928 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007347990059 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 22 . This is a "UPMC FOR KIDS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 22 . This is a "UPMC FOR YOU" identifier . This identifiers is of the category "OTHER".
  • Identifier: 46272 . This is a "GATEWAY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000060304 . This is a "UNISON HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0012586 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00429603 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0001649000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4201515 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 114198400 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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