Individual provider Active NPI

Karen A Medzoyan, MD

  • Psychiatry Physician
  • Lebanon, PA
National Provider Identifier
1275534729
Registry record updated Feb 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD074448-L Issued in PA
Practice address
618 Cumberland Street
Lebanon, PA 17042-5232
Phone
(717) 274-2741
Fax
(717) 274-5405
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2012

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 MD074448-L PA Primary

Addresses

Primary practice location

618 Cumberland Street
Lebanon, PA 17042-5232

Mailing address

200 N. 7TH Street
Lebanon, PA 17046-5040
Phone (717) 273-1710

Other identifiers 1

IdentifierTypeStateIssuer
0019523140006MedicaidPA

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
I20090827000511 PA Practitioner - Psychiatry 8224183280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
State University of New York at Buffalo School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pennsylvania Counseling Services, Inc.Group PAC ID 1355331471, 55 clinicians

Practice addresses (Care Compare)

200 N 7TH St
Lebanon, PA 17046-5040
Phone (717) 272-1653

618 Cumberland St
Lebanon, PA 17042-5232
Phone (717) 274-2741

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD074448-LPAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania Counseling Services Inc. CurrentSince Oct 25, 1996 Accepting new patients

Locations

632 Cumberland St
Lebanon, PA 17042
Phone (717) 273-1710

200 N 7th St
Lebanon, PA 17046
Phone (717) 272-5464

618 Cumberland St
Lebanon, PA 17042
Phone (717) 274-2741

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330387200000",
    "number": "1275534729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N. 7TH STREET",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170465040",
            "telephone_number": "717-273-1710",
            "fax_number": "717-273-1416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 CUMBERLAND STREET",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170425232",
            "telephone_number": "717-274-2741",
            "fax_number": "717-274-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDZOYAN",
        "first_name": "KAREN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2012-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD074448-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019523140006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.