Active NPI
M Ihtesham Janjua, MD
- Psychiatry Physician
- Collegeville, PA
National Provider Identifier
1740268317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD062987L
- Practice address
- 3774 Ridge Pike
Ste 100
Collegeville, PA 19426-3169 - Phone
- (610) 489-3330
- Fax
- (610) 489-9390
- NPI assigned
- Jan 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD062987L | PA | Primary |
Addresses
Primary practice location
3774 Ridge Pike
Ste 100
Collegeville, PA 19426-3169
Mailing address
120 E Tulpehocken St
Philadelphia, PA 19144-2030
Phone (215) 438-3047
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0017593790003 | Medicaid | PA |
Other names 1
- Mohammad Ihtesham
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
230 N 5TH St
Suite 310
Reading, PA 19601-3309
Phone (610) 743-5190
Hospital & facility affiliations
- Penn State Health St. Joseph
- Reading Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD062987L | PA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Horizonz LLC | Psychiatry | Current | Accepting new patients |
| Horizons, LLC | Current | Accepting new patients | |
| Callowhill Family Therapy | Past | Accepting new patients | |
| Pottstown Hospital Company LLC | Past | Accepting new patients |
Locations
640 Walnut St
Ste 301
Reading, PA 19601
Phone (610) 208-8827
4 S 4th St
Fl 2
Reading, PA 19602
Phone (610) 376-8558
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.
-
- Psychiatry Physician
- Reading, PA
- NPI 1043580350
-
- Community/Behavioral Health Agency
- Reading, PA
- NPI 1487021929
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Reading, PA
- NPI 1316009251
-
- Ambulatory Surgical Clinic/Center
- Pottstown, PA
- NPI 1023125929
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- West Reading, PA
- NPI 1467007112
-
- General Acute Care Hospital
- West Reading, PA
- NPI 1669530069
-
- General Acute Care Hospital
- Reading, PA
- NPI 1699734665
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727222400000",
"number": "1740268317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 E TULPEHOCKEN ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191442030",
"telephone_number": "215-438-3047",
"fax_number": "215-438-3042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3774 RIDGE PIKE",
"address_2": "STE 100",
"city": "COLLEGEVILLE",
"state": "PA",
"postal_code": "194263169",
"telephone_number": "610-489-3330",
"fax_number": "610-489-9390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANJUA",
"first_name": "M IHTESHAM",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-04",
"last_updated": "2024-09-25",
"certification_date": "2024-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD062987L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0017593790003",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MOHAMMAD",
"last_name": "IHTESHAM",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Collegeville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.