Individual provider Active NPI

Michelle Mariko Ikoma, M.D.

  • Family Medicine Physician
  • Pittsburgh, PA
National Provider Identifier
1659015345
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD489962 Issued in PA
Practice address
815 Freeport Road, Upmc St. Margaret Dept of Medical Ed
Pittsburgh, PA 15215
Phone
(412) 784-4227
NPI assigned
Apr 27, 2022
Last updated
Jul 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD489962 PA Primary

Addresses

Primary practice location

815 Freeport Road, Upmc St. Margaret Dept of Medical Ed
Pittsburgh, PA 15215

Mailing address

815 Freeport Rd
Pittsburgh, PA 15215-3301
Phone (412) 784-4227

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
I20250731002556 PA Practitioner - Family Practice 4082093505 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upmc Community Medicine IncGroup PAC ID 2062318975, 736 clinicians
University of Pittsburgh PhysiciansGroup PAC ID 8729990239, 4,166 clinicians

Practice addresses (Care Compare)

1072 5TH Ave
New Kensington, PA 15068-6234
Phone (724) 334-3640

200 Lothrop St
Pittsburgh, PA 15213-2546
Phone (412) 383-1370

3937 Butler St
Pittsburgh, PA 15201-3222
Phone (412) 622-7343

5475 Penn Ave
Pittsburgh, PA 15206-3453
Phone (412) 361-7562

815 Freeport Rd
Pittsburgh, PA 15215-3301
Phone (412) 383-3200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Community Medcine Inc Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Upmc Community Medicine, Inc Current Accepting new patients
Upmc Community Medicine Inc Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Upmc St Margaret Past Accepting new patients

Locations

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

339 6th Ave
Fl 5
Pittsburgh, PA 15222
Phone (412) 560-8762

Interoperability endpoints

  • Direct secure messaging: michelle.m.ikoma@upmcdirect.com

Organizations & group practices 5

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 7

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": "1651017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1659015345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 FREEPORT RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152153301",
            "telephone_number": "412-784-4227",
            "fax_number": "412-784-5274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 FREEPORT ROAD, UPMC ST. MARGARET DEPT OF MEDICAL ED",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15215",
            "telephone_number": "412-784-4227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKOMA",
        "first_name": "MICHELLE",
        "middle_name": "MARIKO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-27",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD489962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.