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NPI Code Detail

MEDICARE: SHADYSIDE SURGI-CENTER, INC.

MEDICARE: SHADYSIDE SURGI-CENTER, INC.
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
1261QA1903XAmbulatory Surgical Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20177OTHERPAHIGHMARK ID

General Provider Information

NPI Number : 1952408783
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHADYSIDE SURGI-CENTER, INC.
Provider Business Mailing Address
First Line : 5727 CENTRE AVE
Second Line :
City : PITTSBURGH
State : PA
Zip : 15206-3707
Country : US
Telephone Number : 412-363-6626
Fax Number : 412-363-7008
Provider Business Practice Location Address
First Line : 5727 CENTRE AVE
Second Line :
City : PITTSBURGH
State : PA
Zip : 15206-3707
Country : US
Telephone Number : 412-363-6626
Fax Number : 412-363-7008
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : RAYMOND A CAPONE JR.
Credential : M.D.
Telephone Number : 412-363-6626
Provider Enumeration Date : 09/20/2006
Last Update Date : 09/26/2013

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1871690685 — MARTHA R CLARKE M.D.
Practice Location Address:
5727 CENTRE AVE
PITTSBURGH, PA
15206-3707
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1649377474 — RAYMOND A CAPONE JR. M.D.
Practice Location Address:
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1942308770 — R.A. CAPONE, JR., M.D., P.C.
Practice Location Address:
5727 CENTRE AVE
PITTSBURGH, PA
15206-3707
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Practice Fax: 412-363-7008
1124128970 — KENNETH DAVID HANCOCK D.C.
Practice Location Address:
5713 CENTRE AVE.
PITTSBURGH, PA
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Practice Fax:
1114217643 — AVERY C CAPONE MD
Practice Location Address:
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PITTSBURGH, PA
15206-3707
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1861906786 — STAT ANESTHESIA SPECIALISTS
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Directions to “SHADYSIDE SURGI-CENTER, INC. ” Practice Location

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