Provider Demographics
NPI:1962562561
Name:UPMC PRESBYTERIAN SHADYSIDE
Entity type:Organization
Organization Name:UPMC PRESBYTERIAN SHADYSIDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:412-647-7713
Mailing Address - Street 1:PO BOX 382007
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15250-8007
Mailing Address - Country:US
Mailing Address - Phone:412-432-5500
Mailing Address - Fax:
Practice Address - Street 1:200 LOTHROP ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2536
Practice Address - Country:US
Practice Address - Phone:412-432-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1001064OtherSHY GATEWAY NUMBER
WV0001672000Medicaid
PA0006491150OtherAENTA US HEALTHCARE NUMBE
PA0009609OtherAETNA HMO NUMBER
PA0012010OtherSHY AETNA HMO NUMBER
NJ00690079OtherPUH NJ MEDICAID NUMBER
NY00814902Medicaid
PA0000000140485OtherMEDPLUS NUMBER
PA0013OtherBLUE CROSS NUMBER
WV0101249Medicaid
PA29OtherUPMC FOR YOU NUMBER
PA7066379OtherUNITED HEALTHCARE NUMBER
PA29OtherUPMC HEALTH PLAN NUMBER
PA390164OtherHEALTHAMERICA NUMBER
OH7061889Medicaid
PA1000019040029OtherPA MEDICAID NUMBER
PA1001449OtherGATEWAY NUMBER
PA0009609OtherAETNA HMO NUMBER
PA29OtherUPMC HEALTH PLAN NUMBER
PA29OtherUPMC FOR YOU NUMBER