Individual provider Active NPI

Alicia H Puskar, PSY.D.

  • Clinical Neuropsychologist
  • Pittsburgh, PA
National Provider Identifier
1659613842
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PS017312 Issued in PA
Practice address
3200 S Water St
Pittsburgh, PA 15203-2307
Phone
(412) 432-3600
Fax
(412) 432-3690
NPI assigned
Mar 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS017312 PA
Clinical Psychologist 103TC0700X PS017312 PA
Family Psychologist 103TF0000X PS017312 PA
Clinical Neuropsychologist 103G00000X PS017312 PA Primary

Addresses

Primary practice location

3200 S Water St
Pittsburgh, PA 15203-2307

Mailing address

PO Box 420
Perryopolis, PA 15473-0420
Phone (724) 317-1647

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180110002499 PA Practitioner - Clinical Psychologist 0446499131 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2714 Memorial Blvd
Connellsville, PA 15425-1406
Phone (724) 626-2725

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS017312PAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians Current Accepting new patients
University of Pittsburgh Physicians Clinical Neuropsychologist CurrentSince Dec 29, 2017 Accepting new patients
State of Mind Neuropsychology LLC Clinical Neuropsychologist CurrentSince Apr 1, 2022 Accepting new patients
University of Pittsburgh Physicians CurrentSince Dec 29, 2017 Accepting new patients

Locations

2714 Memorial Blvd
Connellsville, PA 15425
Phone (724) 317-1647

3811 Ohara St
Pittsburgh, PA 15213
Phone (412) 624-2000

200 Lothrop St
Rm 9055
Pittsburgh, PA 15213
Phone (412) 647-8384

3200 S Water St
Pittsburgh, PA 15203
Phone (412) 432-3600

Organizations & group practices 4

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": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1659613842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 420",
            "city": "PERRYOPOLIS",
            "state": "PA",
            "postal_code": "154730420",
            "telephone_number": "724-317-1647",
            "fax_number": "412-647-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S WATER ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152032307",
            "telephone_number": "412-432-3600",
            "fax_number": "412-432-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUSKAR",
        "first_name": "ALICIA",
        "middle_name": "H",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-26",
        "last_updated": "2022-02-09",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS017312",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS017312",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "PA",
            "license": "PS017312",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "PA",
            "license": "PS017312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.