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PRIME MEDICAL GROUP PCG1 NPI 1407098643


NPI Information

NPI: 1407098643
Provider Name: PRIME MEDICAL GROUP PCG1
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 39D0951121

Address:
1645 ROSTRAVER RD
SUITE 202
BELLE VERNON, PA
ZIP 15012
Phone: (724) 929-2260
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PRIME MEDICAL GROUP PCG1 is an internal medicine in Belle Vernon, PA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. PRIME MEDICAL GROUP PCG1 NPI is 1407098643. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1645 ROSTRAVER RD
SUITE 202
BELLE VERNON, PA
ZIP 15012-655
Phone: (724) 929-2260

The provider's authorized official is Darla Sethman .
The authorized official title is Practice Administrator and has the following contact phone number (724) 929-2640.

The CLIA number assigned to this NPI record is 39D0951121 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/2/2009 and was last updated on 8/23/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal MedicineMD036822LPENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10006836970001MEDICAIDPENNSYLVANIA
2PENDINGOTHERPENNSYLVANIAHIGHMARK BLUE SHIELD
3C27989MEDICARE UPINPENNSYLVANIA
4031306K55MEDICARE PINPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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