Active NPI
Purushothama Iyengar, M.D.
- Psychiatry Physician
- Connellsville, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD-042463-L
- Practice address
- 1051 Morrell Ave
Connellsville, PA 15425-3958 - Phone
- (724) 437-0729
- Fax
- (724) 437-2761
- NPI assigned
- May 5, 2006
- Last updated
- May 9, 2017
- Sex
- Male
- Sole proprietor
- No
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 | MD-042463-L | PA | Primary |
Addresses
Primary practice location
1051 Morrell Ave
Connellsville, PA 15425-3958
Mailing address
100 New Salem Rd
Suite 116
Uniontown, PA 15401-8936
Phone (724) 437-0729
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0012961880007 | Medicaid | PA | |
| 329-573-0 | Other | ECFMG | |
| 322242 | Other | MHNET | |
| 618489 | Other | HIGHMARK |
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, 1973
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 New Salem Rd
Suite 116
Uniontown, PA 15401-8936
Phone (724) 437-0729
1321 Connellsville Rd
Lemont Furnace, PA 15456-1009
Phone (724) 437-0729
505 N Pittsburgh St
Connellsville, PA 15425-3220
Phone (724) 437-0729
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-042463-L | PA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chestnut Ridge Counseling Services Inc | Psychiatry | Current | Accepting new patients |
| Pennsylvania Department of Human Services | Current | Accepting new patients | |
| Pennsylvania Department of Public Welfare | Current | Accepting new patients | |
| Penn Psycare Inc | Psychiatry | Past | Accepting new patients |
Locations
1051 Morrell Ave
Connellsville, PA 15425
Phone (724) 427-0729
100 New Salem Rd
Ste 116
Uniontown, PA 15401
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Uniontown, PA
- NPI 1063489482
Psychiatry
-
dba Torrance State Hospital
- Psychiatric Hospital
- Torrance, PA
- NPI 1376526111
-
dba Allentown State Hospital
- Psychiatric Hospital
- Allentown, PA
- NPI 1386626919
-
- Psychiatry Physician
- Lower Burrell, PA
- NPI 1326004425
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Connellsville, PA
- NPI 1124053467
-
dba Penn Highlands Connellsville
- General Acute Care Hospital
- Connellsville, PA
- NPI 1144215039
-
dba Penn Highlands Connellsville
- Internal Medicine Physician
- Connellsville, PA
- NPI 1518680164
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494288000000",
"number": "1811945140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 NEW SALEM RD",
"address_2": "SUITE 116",
"city": "UNIONTOWN",
"state": "PA",
"postal_code": "154018936",
"telephone_number": "724-437-0729",
"fax_number": "724-437-2761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1051 MORRELL AVE",
"city": "CONNELLSVILLE",
"state": "PA",
"postal_code": "154253958",
"telephone_number": "724-437-0729",
"fax_number": "724-437-2761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IYENGAR",
"first_name": "PURUSHOTHAMA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2017-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD-042463-L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0012961880007",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ECFMG",
"identifier": "329-573-0",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHNET",
"identifier": "322242",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK",
"identifier": "618489",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Connellsville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2017; 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.