Individual provider Active NPI

Kevin Jackson Whitley, MD

  • Psychiatry Physician
  • Pittsburgh, PA
National Provider Identifier
1790988780
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD451811 Issued in PA
Practice address
2575 Boyce Plaza Rd
Pittsburgh, PA 15241-3925
Phone
(412) 257-2290
Fax
(412) 206-0217
NPI assigned
Jun 7, 2007
Last updated
Jul 27, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD451811 PA Primary
Child & Adolescent Psychiatry Physician 2084P0804X MD451811 PA

Addresses

Primary practice location

2575 Boyce Plaza Rd
Pittsburgh, PA 15241-3925

Mailing address

1035 Murray Hill Ave
Pittsburgh, PA 15217-1039
Phone (205) 821-4230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140718001900 PA Practitioner - PsychiatryPractitioner - Other (Physician) 9638313497 Reassigns benefits to 2 organizations
I20221212000134 MA Practitioner - Psychiatry 9638313497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Alabama School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
T Massachusetts, LLCGroup PAC ID 6901159003, 20 clinicians

Practice addresses (Care Compare)

100 Century Dr
Worcester, MA 01606-1244
Phone (884) 319-0000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians Psychiatry CurrentSince Aug 1, 2014 Accepting new patients
University of Pittsburgh Physicians CurrentSince Aug 1, 2014 Accepting new patients
T Massachusetts, LLC CurrentSince Oct 17, 2022 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Western PA Behavioral Health Resources LLC Psychiatry CurrentSince Aug 5, 2019 Accepting new patients

Locations

100 Century Dr
Worcester, MA 01606
Phone (508) 762-5400

111 Roberts Rd
Ste 150
Grindstone, PA 15442
Phone (724) 785-4346

707 Ligonier St
Latrobe, PA 15650
Phone (724) 537-9515

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

5301 Grove Rd
Ste M123
Pittsburgh, PA 15236
Phone (412) 677-9100

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.

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469577600000",
    "number": "1790988780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 MURRAY HILL AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152171039",
            "telephone_number": "205-821-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 BOYCE PLAZA RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152413925",
            "telephone_number": "412-257-2290",
            "fax_number": "412-206-0217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLEY",
        "first_name": "KEVIN",
        "middle_name": "JACKSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2016-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD451811",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD451811",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.