Individual provider Active NPI

Charles B Mormando, DO

  • Psychiatry Physician
  • Harrisburg, PA
National Provider Identifier
1366853624
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
OS019370 Issued in PA
Practice address
2501 N 3Rd St
Harrisburg, PA 17110
Phone
(717) 782-4734
Fax
(717) 782-4727
NPI assigned
May 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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 OS019370 PA Primary

Addresses

Primary practice location

2501 N 3Rd St
Harrisburg, PA 17110

Mailing address

PO Box 858
MC A410
Hershey, PA 17033-0858
Phone (800) 243-1455

Other practice location 1

500 University Dr
Hershey, PA 17033-2360
Phone (800) 243-1455

Other identifiers 1

IdentifierTypeStateIssuer
1035174690001MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmormando76260@phsdirect.pinnaclehealth.org

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
I20180806001000 PA Practitioner - Psychiatry 4082962121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2501 N 3Rd St
Penn State Hershey Psychiatric
Harrisburg, PA 17110-2098
Phone (717) 782-6420

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as group
Quality
56.69
Promoting interoperability
100
Improvement activities
40
Cost
74.52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS019370PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physicians Group Psychiatry CurrentSince Aug 1, 2018 Accepting new patients
Pennsylvania Psychiatric Institute CurrentSince Aug 1, 2018 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Aug 1, 2018 Accepting new patients
Pennsylvania Psychiatric Institute CurrentSince Aug 1, 2018 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients

Locations

2501 N 3rd St
Harrisburg, PA 17110
Phone (717) 782-2100

401 Division St
Harrisburg, PA 17110
Phone (717) 782-4349

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

Organizations & group practices 5

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": "1399507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1366853624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "address_2": "MC A410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N 3RD ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "17110",
            "telephone_number": "717-782-4734",
            "fax_number": "717-782-4727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "800-243-1455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORMANDO",
        "first_name": "CHARLES",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-08",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "OS019370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035174690001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmormando76260@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "endpointDescription": "direct email",
            "address_1": "2501 N 3rd St",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "17110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.