MEDICARE: UPMC COMMUNITY MEDICINE, 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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1457870164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPMC COMMUNITY MEDICINE, INC.

Provider Business Mailing Address
First Line	:	2008 W STATE ST
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16101-1248
Country	:	US
Telephone Number	:	724-654-8719
Fax Number	:	724-657-2086

Provider Business Practice Location Address
First Line	:	2008 W STATE ST
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16101-1248
Country	:	US
Telephone Number	:	724-654-8719
Fax Number	:	724-657-2086

Authorized Official
Title or Position	:	DIRECTOR REVENUE CYCLE
Name	:	PATRICIA DEVLIN
Credential	:
Telephone Number	:	412-432-7469

Provider Enumeration Date	:	09/13/2017
Last Update Date	:	07/21/2022

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