Individual provider Active NPI

Maurice Ralph Picciotto, M.D.

  • Psychiatry Physician
  • Harrisburg, PA
National Provider Identifier
1376652487
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD030316E Issued in PA
Practice address
2209 Forest Hills Dr
Suite 19
Harrisburg, PA 17112-1095
Phone
(717) 540-4420
Fax
(717) 540-4427
NPI assigned
Aug 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MD030316E PA Primary

Addresses

Primary practice location

2209 Forest Hills Dr
Suite 19
Harrisburg, PA 17112-1095

Mailing address

2209 Forest Hills Dr
Suite 19
Harrisburg, PA 17112-1095
Phone (717) 540-4420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040719001243 PA Practitioner - Psychiatry 8820077167 Reassigns benefits to 3 organizations
I20090415000532 NY Practitioner - Psychiatry 8820077167 Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Truenorth Wellness ServicesGroup PAC ID 6709869456, 20 clinicians

Practice addresses (Care Compare)

119 Lincolnway W
McConnellsburg, PA 17233-1302
Phone (717) 485-3264

53512 Jaycee Ave
Suite 1
Harrisburg, PA 17112
Phone (717) 632-4900

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
T.W. Ponessa & Associates Counseling Services, Inc. CurrentSince May 2, 2011 Accepting new patients
NHS Stevens Center CurrentSince Mar 18, 2017 Accepting new patients
Truenorth Wellness Services CurrentSince Aug 28, 2007 Accepting new patients
NHS Stevens Center CurrentSince Mar 18, 2017 Accepting new patients
Truenorth Wellness Services CurrentSince Aug 28, 2007 Accepting new patients
Truenorth Wellness Services Current Accepting new patients
Family Care for Children & Youth, Inc. Past Accepting new patients

Locations

33 State Ave
Carlisle, PA 17013
Phone (215) 375-1970

625 W Elm Ave
Hanover, PA 17331

620 Germantown Pike
Lafayette Hl, PA 19444
Phone (313) 278-2327

410 N Prince St
Lancaster, PA 17603

15 S 9th St
Lebanon, PA 17042
Phone (717) 273-5992

1195 Roosevelt Ave
York, PA 17404
Phone (717) 843-0800

160 Roosevelt Ave
Ste 300
York, PA 17401
Phone (717) 845-2425

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376652487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 FOREST HILLS DR",
            "address_2": "SUITE 19",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171121095",
            "telephone_number": "717-540-4420",
            "fax_number": "717-540-4427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 FOREST HILLS DR",
            "address_2": "SUITE 19",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171121095",
            "telephone_number": "717-540-4420",
            "fax_number": "717-540-4427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICCIOTTO",
        "first_name": "MAURICE",
        "middle_name": "RALPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD030316E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.