Basic Information
| Provider Information | |||||||||
| NPI: | 1861478307 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UPMC KANE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 GRANT STREET, US STEEL TOWER, 59TH FLOOR | ||||||||
| Address2: | C/O RENEE JOHNSON | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152192740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126236303 | ||||||||
| FaxNumber: | 4126236369 | ||||||||
| Practice Location | |||||||||
| Address1: | 4372 ROUTE 6 | ||||||||
| Address2: | |||||||||
| City: | KANE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 167353060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148378585 | ||||||||
| FaxNumber: | 8148377992 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2005 | ||||||||
| LastUpdateDate: | 02/04/2020 | ||||||||
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| AuthorizedOfficialLastName: | DINGER | ||||||||
| AuthorizedOfficialFirstName: | BRAD | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8148373739 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 02/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | 550501 | PA | N | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical | 207L00000X | 550501 | PA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | 550501 | PA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207Q00000X | 550501 | PA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 207R00000X | 550501 | PA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 208600000X | 550501 | PA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | 261Q00000X | 550501 | PA | N | Ambulatory Health Care Facilities | Clinic/Center | 282N00000X | 550501 | PA | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 0049 | 01 | PA | BLUE CROSS 363 ACUTE | OTHER | 1007457740047 | 05 | PA | MEDICAID | 1007457740004 | 05 | PA | MEDICAID | 102396 | 01 | PA | NOVITAS SOLUTIONS | OTHER | 1439302 | 01 | PA | KCH BLUE SHIELD SURGICAL | OTHER | CA5757 | 01 | PA | PALMETTO GBA | OTHER | 1007457740039 | 05 | PA | MEDICAID | 105034 | 01 | PA | UPMC | OTHER | 2980734 | 01 | PA | HIGHMARK BLUE SHIELD ANESTHESIOLOGY | OTHER | 1007457740048 | 05 | PA | MEDICAID | 1902214 | 01 | PA | KCH BLUE SHIELD | OTHER | 2980741 | 01 | PA | HIGHMARK BS ANESTHESIA | OTHER |