Provider Demographics
| NPI: | 1902122930 |
|---|---|
| Name: | WEST PENN ALLEGHENY HEALTH SYSTEM, INC. |
| Entity type: | Organization |
| Organization Name: | WEST PENN ALLEGHENY HEALTH SYSTEM, INC. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | ENROLLMENT SPECIALIST |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | CECILI |
| Authorized Official - Middle Name: | R |
| Authorized Official - Last Name: | JONES |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 412-330-4813 |
| Mailing Address - Street 1: | PO BOX 90261 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | PITTSBURGH |
| Mailing Address - State: | PA |
| Mailing Address - Zip Code: | 15224-0761 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 866-907-7551 |
| Mailing Address - Fax: | 412-578-0259 |
| Practice Address - Street 1: | 2 ALLEGHENY CTR |
| Practice Address - Street 2: | SIXTH FLOOR |
| Practice Address - City: | PITTSBURGH |
| Practice Address - State: | PA |
| Practice Address - Zip Code: | 15212-5402 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 412-330-4813 |
| Practice Address - Fax: | 412-330-5522 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2010-04-15 |
| Last Update Date: | 2010-04-15 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| PA | 122300000X, 207RC0000X, 207RI0011X, 207RP1001X, 2080N0001X, 2082S0105X, 2086S0127X, 213E00000X, 208600000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 122300000X | Dental Providers | Dentist | Group - Multi-Specialty | |
| No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
| No | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | Group - Multi-Specialty |
| No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
| No | 2080N0001X | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine | Group - Multi-Specialty |
| No | 2082S0105X | Allopathic & Osteopathic Physicians | Plastic Surgery | Surgery of the Hand | Group - Multi-Specialty |
| No | 2086S0127X | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | Group - Multi-Specialty |
| No | 213E00000X | Podiatric Medicine & Surgery Service Providers | Podiatrist | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| PA | 1007277200089 | Medicaid | |
| PA | 1007277200071 | Medicaid | |
| OH | 2355688 | Medicaid | |
| WV | 3810010815 | Medicaid | |
| WV | 3810010817 | Medicaid | |
| PA | 1007277200001 | Medicaid | |
| PA | 1007277200106 | Medicaid | |
| PA | 1007277200012 | Medicaid | |
| OH | 2959820 | Medicaid | |
| PA | 1007277200081 | Medicaid | |
| OH | 2750269 | Medicaid | |
| ME | 432728800 | Medicaid | |
| PA | 1007277200078 | Medicaid | |
| WV | 3810004774 | Medicaid | |
| OH | 2879596 | Medicaid | |
| WV | 3810008519 | Medicaid | |
| OH | 2959820 | Medicaid | |
| PA | 122063 | Medicare PIN | |
| PA | CK2286 | Medicare PIN | |
| PA | 1007277200089 | Medicaid | |
| PA | 1007277200071 | Medicaid | |
| PA | 1007277200078 | Medicaid | |
| PA | 1007277200106 | Medicaid | |
| PA | 1007277200081 | Medicaid | |
| WV | 3810010817 | Medicaid |
