Active NPI
John P Nelson, M.D.
- Psychiatry Physician
- Pittsburgh, PA
National Provider Identifier
1053307249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD028096E
- Practice address
- 401 Shady Ave
D-108
Pittsburgh, PA 15206-4460 - Phone
- (412) 661-9008
- Fax
- (412) 661-1055
- NPI assigned
- Sep 22, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD028096E | PA | Primary |
| Geriatric Psychiatry Physician | 2084P0805X | MD028096E | PA |
Addresses
Primary practice location
401 Shady Ave
D-108
Pittsburgh, PA 15206-4460
Mailing address
401 Shady Ave
D-108
Pittsburgh, PA 15206-4460
Phone (412) 661-9008
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| N197917 | Other | PA | HIGHMARK BC/BS |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101021000036 | PA | Practitioner - Psychiatry | 4789877838 | Practice locations: Pittsburgh, PA |
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Harvard Medical School, 1967
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
401 Shady Ave
D 108
Pittsburgh, PA 15206-4460
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1053307249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 SHADY AVE",
"address_2": "D-108",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152064460",
"telephone_number": "412-661-9008",
"fax_number": "412-661-1055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 SHADY AVE",
"address_2": "D-108",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152064460",
"telephone_number": "412-661-9008",
"fax_number": "412-661-1055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "JOHN",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-22",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD028096E",
"primary": true
},
{
"code": "2084P0805X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Geriatric Psychiatry",
"state": "PA",
"license": "MD028096E",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BC/BS",
"identifier": "N197917",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pittsburgh, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.