Mounika Mukherjee Peethala

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MT228501 Issued in PA

Practice address

34 S Railroad St
Tamaqua, PA 18252-1927

Phone

(570) 645-1950

Fax

(833) 679-4141

NPI assigned

May 22, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1013609957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 S RAILROAD ST",
            "city": "TAMAQUA",
            "state": "PA",
            "postal_code": "182521927",
            "telephone_number": "570-645-1950",
            "fax_number": "833-679-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 S RAILROAD ST",
            "city": "TAMAQUA",
            "state": "PA",
            "postal_code": "182521927",
            "telephone_number": "570-645-1950",
            "fax_number": "833-679-4141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 S. Greenwood Avenue",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "PA",
            "postal_code": "18045",
            "country_code": "US",
            "telephone_number": "484-503-4007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEETHALA",
        "first_name": "MOUNIKA MUKHERJEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT228501",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT228501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ophthalmic Partners of Pennsylvania, PC
• Joseph S Pancher, OD
• Cassandra J Pastier, OD
• Dhwani B Patel, DO
• Pamela Peduto, PT
• Phoenix Rehabilitation and Health Services, Inc
• Physical Therapy Services of Hometown, Inc.
• Physical Therapy Services of Hometown, Inc.
• Physical Therapy Services of Hometown, Inc.
• Shannon Clare Pirich, CRNP

• All providers in Tamaqua, PA
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.