NPIMap

Individual provider Active NPI

Abhinav Ettyreddy, M.D.

  • Otology & Neurotology Physician
  • Wexford, PA
National Provider Identifier
1487004891
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otology & Neurotology PhysicianTaxonomy code 207YX0901X
License
MD480651 Issued in PA
Practice address
6041 Wallace Road Ext Ste 110
Wexford, PA 15090-7471
Phone
(412) 321-7047
NPI assigned
Jun 16, 2016
Last updated
Apr 4, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otology & Neurotology Physician 207YX0901X MD480651 PA Primary

Addresses

Primary practice location

6041 Wallace Road Ext Ste 110
Wexford, PA 15090-7471

Mailing address

6041 Wallace Road Ext Ste 110
Wexford, PA 15090-7471

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
I20230706002725 PA Practitioner - Otolaryngology 9436558822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Pittsburgh School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, shared by 15 NPIs, 750 clinicians
Pittsburgh Ear Associates PCGroup PAC ID 5294708426, 9 clinicians

Practice addresses (Care Compare)

203 High Pointe Dr
Suite 100
Seven Fields, PA 16046-7921
Phone (724) 742-1250

6041 Wallace Rd Ext
Suite 110
Wexford, PA 15090-7471
Phone (412) 321-2480

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pittsburgh Ear Associates PC Otology & Neurotology CurrentSince Aug 1, 2023 Accepting new patients
Pittsburgh Ear LLC CurrentSince Apr 9, 2023 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

200 James Pl
Ste 406
Monroeville, PA 15146
Phone (412) 321-2480

420 E North Ave
Ste 402
Pittsburgh, PA 15212
Phone (412) 321-2480

6041 Wallace Road Ext
Ste 110
Wexford, PA 15090
Phone (412) 321-2480

Interoperability endpoints

  • Direct secure messaging: aettyreddy@directaddress.net

Organizations & group practices 3

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1487004891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6041 WALLACE ROAD EXT STE 110",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150907471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6041 WALLACE ROAD EXT STE 110",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150907471",
            "telephone_number": "412-321-7047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTYREDDY",
        "first_name": "ABHINAV",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-16",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "PA",
            "license": "MD480651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wexford, PA

Sources for this page

Verify at the official NPI Registry.