Individual provider Active NPI

Madhusmita Sahoo, MD

  • Psychiatry Physician
  • Philadelphia, PA
National Provider Identifier
1912499377
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD46690 Issued in PA
Practice address
4641 Roosevelt Blvd
Philadelphia, PA 19124-2398
Phone
(215) 831-7942
NPI assigned
Jun 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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 MD46690 PA Primary
Child & Adolescent Psychiatry Physician 2084P0804X 25MA10179400 NJ

Addresses

Primary practice location

4641 Roosevelt Blvd
Philadelphia, PA 19124-2398

Mailing address

4031 Hermitage Dr
Voorhees, NJ 08043-4186
Phone (732) 742-5743

Other practice location 1

671 Hoes Ln W
Piscataway, NJ 08854-8021
Phone (732) 235-5256

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
I20191009001875 PA Practitioner - Psychiatry 2567793383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Pennsylvania Physician Alliance, LLCGroup PAC ID 8325478662, 112 clinicians

Practice addresses (Care Compare)

4641 Roosevelt Blvd
Philadelphia, PA 19124-2343
Phone (215) 831-4600

Hospital & facility affiliations

  • Jefferson Health- Northeast Hospital, Philadelphia, PA, CCN 390115
  • Nazareth Hospital Hospital, Philadelphia, PA, CCN 390204

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
78.42
Improvement activities
40
Cost
70.24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD46690PAMDPsychiatry Physician
25MA10179400NJMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Pennsylvania Physician Alliance LLC Child & Adolescent Psychiatry CurrentSince Jun 1, 2020 Accepting new patients

Locations

2 Hospital Dr
Clarion, PA 16214
Phone (800) 253-4906

722 E Butler Pike
Maple Glen, PA 19002
Phone (215) 643-7800

4641 E Roosevelt Blvd
Philadelphia, PA 19124
Phone (215) 831-4600

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1912499377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4031 HERMITAGE DR",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434186",
            "telephone_number": "732-742-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191242398",
            "telephone_number": "215-831-7942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "671 Hoes Ln W",
            "address_purpose": "LOCATION",
            "city": "Piscataway",
            "state": "NJ",
            "postal_code": "088548021",
            "country_code": "US",
            "telephone_number": "732-235-5256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAHOO",
        "first_name": "MADHUSMITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-01",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD46690",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "25MA10179400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.