Provider Demographics
NPI:1275584161
Name:SPECIALTY ORTHOPAEDICS, P.C.
Entity Type:Organization
Organization Name:SPECIALTY ORTHOPAEDICS, P.C.
Other - Org Name:ROBERT W. PISTON, M.D., P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:PISTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-342-2663
Mailing Address - Street 1:3120 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-4512
Mailing Address - Country:US
Mailing Address - Phone:724-342-2663
Mailing Address - Fax:
Practice Address - Street 1:3120 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-4512
Practice Address - Country:US
Practice Address - Phone:724-342-2663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007775620009Medicaid
OH2544376OtherOHIO MED ASSISTANCE GRP #
PA1007775620011OtherPA MA PT/OT GROUP
PA39D1023133OtherCLIA LAB #
1007775620010OtherPA MA PODIATRY GROUP
PA000652655OtherBS PT ID
002022587OtherBS PODIATRY GROUP
111143OtherHEALTH AMERICA
V04902OtherUPMC
000762543OtherBS PHYSICIAN GROUP
PA120437900OtherPA DEPT OF LABOR
PA000622164OtherBS OT ID
PACG9009OtherTRAVELERS/RR MEDICARE
PA=========OtherFEDERAL TAX IDENTIFICATION NUMBER
V04902OtherUPMC
002022587OtherBS PODIATRY GROUP