NPIMap

Individual provider Active NPI

Justin Prakorb Isariyawongse, M.D.

  • Urology Physician
  • Monroeville, PA
National Provider Identifier
1053524769
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD448991 Issued in PA
Practice address
2790 Mosside Blvd Ste G110
Monroeville, PA 15146-2766
Phone
(412) 702-0030
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 57.010506 OH
Urology Physician 208800000X MD448991 PA Primary

Addresses

Primary practice location

2790 Mosside Blvd Ste G110
Monroeville, PA 15146-2766

Mailing address

2790 Mosside Blvd Ste G110
Monroeville, PA 15146-2766
Phone (412) 702-0030

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130808000304 PA Practitioner - Urology 8426290198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Ohio State University College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Suburban Urologic Associates PCGroup PAC ID 8123098209, 9 clinicians

Practice addresses (Care Compare)

2790 Mosside Blvd
Suite G110
Monroeville, PA 15146-2766
Phone 4123726330112

575 Coal Valley Rd
Suite 571
Clairton, PA 15025-3729
Phone (412) 469-7108

Hospital & facility affiliations

  • Jefferson Hospital Hospital, Jefferson Hills, PA, CCN 390265
  • Forbes Hospital Hospital, Monroeville, PA, CCN 390267
  • Excela Health Westmoreland Regional Hospital Hospital, Greensburg, PA, CCN 390145
  • West Penn Hospital Hospital, Pittsburgh, PA, CCN 390090
  • Uniontown Hospital Hospital, Uniontown, PA, CCN 390041

Merit-based Incentive Payment System (MIPS)

Final score
91.13 of 100Reported as group
Quality
100
Improvement activities
40
Cost
70.44

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.010506OHMDUrology Physician
MD448991PAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Urologic Associates P.C. Urology CurrentSince Aug 26, 2013 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

575 Coal Valley Rd
Ste 571
Clairton, PA 15025
Phone (412) 469-7107

2790 Mosside Blvd
Ste G110
Monroeville, PA 15146
Phone (412) 372-6330

2580 Haymaker Rd
Ste 401
Monroeville, PA 15146
Phone (412) 372-6330

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FBBIDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/FBBIDD/Endpoint/FBBIDD

Organizations & group practices 2

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.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1053524769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 MOSSIDE BLVD STE G110",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462766",
            "telephone_number": "412-702-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 MOSSIDE BLVD STE G110",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462766",
            "telephone_number": "412-702-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISARIYAWONGSE",
        "first_name": "JUSTIN",
        "middle_name": "PRAKORB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "57.010506",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD448991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

Verify at the official NPI Registry.