1275584161 NPI number — SPECIALTY ORTHOPAEDICS, P.C.

Table of content: (NPI 1275584161)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275584161 NPI number — SPECIALTY ORTHOPAEDICS, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPECIALTY ORTHOPAEDICS, P.C.
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:
6
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:
1275584161
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/02/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3120 HIGHLAND RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HERMITAGE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16148-4512
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-342-2663
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3120 HIGHLAND RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HERMITAGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16148-4512
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-342-2663
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PISTON
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
W
Authorized Official Title or Position:
PRESIDENT CEO
Authorized Official Telephone Number:
724-342-2663

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251X0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AS0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000622164 . This is a "BS OT ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007775620010 . This is a "PA MA PODIATRY GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1007775620011 . This is a "PA MA PT/OT GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 120437900 . This is a "PA DEPT OF LABOR" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000762543 . This is a "BS PHYSICIAN GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 002022587 . This is a "BS PODIATRY GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 111143 . This is a "HEALTH AMERICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000652655 . This is a "BS PT ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007775620009 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2544376 . This is a "OHIO MED ASSISTANCE GRP #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 39D1023133 . This is a "CLIA LAB #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: CG9009 . This is a "TRAVELERS/RR MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: V04902 . This is a "UPMC" identifier . This identifiers is of the category "OTHER".




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