Individual provider Active NPI

Emil Ivanov, MD

  • Psychiatry Physician
  • Pittsburgh, PA
National Provider Identifier
1013024751
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD427791 Issued in PA
Practice address
3811 Ohara St
Pittsburgh, PA 15213-2593
Phone
(412) 246-6801
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD427791 PA Primary

Addresses

Primary practice location

3811 Ohara St
Pittsburgh, PA 15213-2593

Mailing address

3811 Ohara St
Pittsburgh, PA 15213-2593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060503000048 PA Practitioner - Psychiatry 3577573955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pittsburgh Psychiatry LLCGroup PAC ID 3870878002, 2 clinicians

Practice addresses (Care Compare)

645 Rodi Rd
Suite 200
Penn Hills, PA 15235-4569
Phone (412) 345-3517

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pittsburgh Psychiatry LLC Psychiatry CurrentSince Oct 12, 2016 Accepting new patients

Locations

645 Rodi Rd
Ste 200
Pittsburgh, PA 15235
Phone (412) 345-3517

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1013024751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 OHARA ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152132593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 OHARA ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152132593",
            "telephone_number": "412-246-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVANOV",
        "first_name": "EMIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD427791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.