Individual provider Active NPI

Sujatha Pandian, MD

  • Psychiatry Physician
  • Rochester, PA
National Provider Identifier
1508867086
Registry record updated Jun 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD420452 Issued in PA
Practice address
176 Virginia Ave
Rochester, PA 15074-1723
Phone
(724) 770-9095
Fax
(724) 770-9096
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2017

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 MD420452 PA Primary

Addresses

Primary practice location

176 Virginia Ave
Rochester, PA 15074-1723

Mailing address

100 Shenango Ave
Sharon, PA 16146-1503
Phone (724) 770-9095

Other identifiers 3

IdentifierTypeStateIssuer
3810001134MedicaidWV
0019472250001MedicaidPA
2440700MedicaidOH

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
I20040910000361 PA Practitioner - Psychiatry 2365419389 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD420452PAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Health Network CurrentSince Jan 2, 2015 Accepting new patients
Primary Health Network CurrentSince Jan 2, 2015 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

2000 Green St
Farrell, PA 16121
Phone (724) 342-6600

176 Virginia Ave
Rochester, PA 15074
Phone (724) 770-9095

63 Pitt St
Sharon, PA 16146
Phone (724) 342-6604

100 Shenango Ave
Sharon, PA 16146
Phone (724) 704-8886

Interoperability endpoints

  • Direct secure messaging: sujathapandian@primaryhn.medalliesdirect.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497225600000",
    "number": "1508867086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SHENANGO AVE",
            "city": "SHARON",
            "state": "PA",
            "postal_code": "161461503",
            "telephone_number": "724-770-9095",
            "fax_number": "724-770-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 VIRGINIA AVE",
            "city": "ROCHESTER",
            "state": "PA",
            "postal_code": "150741723",
            "telephone_number": "724-770-9095",
            "fax_number": "724-770-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDIAN",
        "first_name": "SUJATHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2017-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD420452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810001134",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019472250001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2440700",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, PA

Sources for this page

Verify at the official NPI Registry.