Individual provider Active NPI

Lydia Joy Peluso, PA-C

  • Physician Assistant
  • Pittsburgh, PA
National Provider Identifier
1508520388
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
200 Lothrop St
Pittsburgh, PA 15213-2536
Phone
(412) 647-2345
NPI assigned
Oct 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

200 Lothrop St
Pittsburgh, PA 15213-2536

Mailing address

2827 Telek PL Apt 1617
Alexandria, VA 22314-4865
Phone (724) 712-6964

Other names 1

  • Lydia Joy Pollum Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241029002865 PA Practitioner - Physician Assistant 2769847847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Pittsburgh PhysiciansGroup PAC ID 8729990239, 4,166 clinicians

Practice addresses (Care Compare)

200 Lothrop St
Pittsburgh, PA 15213-2536

3459 5TH Ave
Pittsburgh, PA 15213-3236
Phone (412) 648-6161

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince Oct 9, 2024 Accepting new patients
University of Pittsburgh Physicians CurrentSince Oct 9, 2024 Accepting new patients

Locations

3459 5th Ave
#G
Pittsburgh, PA 15213
Phone (412) 648-6161

200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

Interoperability endpoints

  • Direct secure messaging: lydia.j.peluso@upmcdirect.com

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 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": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1508520388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2827 TELEK PL APT 1617",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223144865",
            "telephone_number": "724-712-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LOTHROP ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152132536",
            "telephone_number": "412-647-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELUSO",
        "first_name": "LYDIA",
        "middle_name": "JOY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYDIA",
            "last_name": "POLLUM",
            "middle_name": "JOY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.