MEDICARE: UPMC/HVHS CANCER CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	095764	OTHER	PA	PA MEDICARE IDTF

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	1556237	OTHER	PA	HIGHMARK

General Provider Information

NPI Number	:	1609843861
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPMC/HVHS CANCER CENTER

Provider Business Mailing Address
First Line	:	2 HOT METAL ST
Second Line	:	QUANTUM ONE, N430
City	:	PITTSBURGH
State	:	PA
Zip	:	15203-2348
Country	:	US
Telephone Number	:	412-432-7706
Fax Number	:	412-432-7691

Provider Business Practice Location Address
First Line	:	1600 CORAOPOLIS HEIGHTS RD
Second Line	:
City	:	MOON TOWNSHIP
State	:	PA
Zip	:	15108-4316
Country	:	US
Telephone Number	:	412-604-2020
Fax Number	:	412-604-2046

Authorized Official
Title or Position	:	VICE PRESIDENT - CANCER SERVICES
Name	:	CHARLES E BOGOSTA
Credential	:
Telephone Number	:	412-692-2451

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	10/09/2008

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Directions to “UPMC/HVHS CANCER CENTER ” Practice Location

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