Individual provider Active NPI

Attiya Kidwai, M.D

  • Psychiatry Physician
  • York, PA
National Provider Identifier
1508158130
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD454584 Issued in PA
Practice address
1101 Edgar St
York, PA 17403-2862
Phone
(717) 851-1500
Fax
(717) 851-1515
NPI assigned
May 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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 MD454584 PA Primary

Addresses

Primary practice location

1101 Edgar St
York, PA 17403-2862

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Other practice location 1

169 Martin Ave
Ephrata, PA 17522-1734
Phone (717) 733-0311

Other practice location 2

283 S Butler Rd
Lebanon, PA 17042-8939
Phone (717) 273-8871

Other practice location 3

1001 S George St
York, PA 17403-3676
Phone (717) 851-2304

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
I20150813010042 PA Practitioner - Psychiatry 9436464989 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

1001 S George St
Wellspan Philhaven
York, PA 17402-3676
Phone (717) 851-2304

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Philhaven CurrentSince Jan 14, 2024 Accepting new patients
Wellspan Medical Group CurrentSince Jan 18, 2016 Accepting new patients
Philhaven Psychiatry Current Accepting new patients
York Hospital CurrentSince Jun 29, 2015 Accepting new patients
Wellspan Medical Group CurrentSince Jan 18, 2016 Accepting new patients
York Hospital Psychiatry CurrentSince Jun 29, 2015 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Philhaven CurrentSince Jan 14, 2024 Accepting new patients

Locations

169 Martin Ave
Ephrata, PA 17522
Phone (717) 733-0311

6375 Chambersburg Rd
Fayetteville, PA 17222
Phone (717) 352-2721

2501 Oregon Pike
Ste 113
Lancaster, PA 17601
Phone (717) 735-1954

283 S Butler Rd
Lebanon, PA 17042

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

1001 S George St
York, PA 17403
Phone (717) 812-7687

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

1101 Edgar St
York, PA 17403
Phone (717) 812-4602

1600 S George St
York, PA 17403
Phone (717) 848-3615

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

605 S George St
Ste 200
York, PA 17401
Phone (717) 851-2334

Interoperability endpoints

  • Direct secure messaging: akidwai14159@wellspan.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1508158130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405",
            "fax_number": "717-851-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 EDGAR ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174032862",
            "telephone_number": "717-851-1500",
            "fax_number": "717-851-1515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Martin Ave",
            "address_purpose": "LOCATION",
            "city": "Ephrata",
            "state": "PA",
            "postal_code": "175221734",
            "country_code": "US",
            "telephone_number": "717-733-0311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "283 S Butler Rd",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170428939",
            "country_code": "US",
            "telephone_number": "717-273-8871",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 S George St",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174033676",
            "country_code": "US",
            "telephone_number": "717-851-2304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIDWAI",
        "first_name": "ATTIYA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-16",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD454584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.