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DR. PRIYA CARDONE D.O.
NPI 1568819720
Psychiatry & Neurology - Neurology in Wexford, PA

Active since May 18, 2016PECOS EnrolledAccepts Medicare Assignment
77.5/100
CMS Quality Rating
12680 PERRY HWY DEPT OF, WEXFORD, PA 15090(412) 748-5543 Get Directions Write a Review

NPPES record last updated: November 4, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 4, 2021, May 18, 2016 (2 updates tracked since 2016).

About Dr. Priya Cardone D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PRIYA CARDONE D.O. (NPI 1568819720) is an individual neurology provider in Wexford, Pennsylvania, licensed in Pennsylvania (OS021669) and active in the NPI registry since May 2016. She is enrolled in Medicare PECOS, is affiliated with Upmc St Margaret, and is a graduate of Lake Erie College Of Osteopathic Medicine, Erie (2016).

NPPES Registry Identity

NPI1568819720
Entity TypeIndividualFemale
Primary Taxonomy2084N0400X
Provider Legal NameDR. PRIYA CARDONECredential: D.O.
Location Address12680 PERRY HWY DEPT OFWexford, PA 15090-8886
Mailing Address12680 Perry Hwy Dept OfWexford, PA 15090-8886 · (412) 748-5543
Phone(412) 748-5543
Sole ProprietorNo
Medical School CMSLake Erie College Of Osteopathic Medicine, ErieGraduated 2016
Enumeration DateMay 18, 2016
Last NPPES UpdateNovember 4, 20212 updates tracked since enumeration
NPPES CertifiedNovember 4, 2021
✔ NPI 1568819720 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License✔ Licensed in PA · OS021669
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
12680 PERRY HWY DEPT OF, Wexford, PA 15090
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Priya Cardone D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5496049827
PECOS Enrollment IDI20211117001380
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
150 services99 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
47 services47 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
34 services33 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Upmc St Margaret

Acute Care Hospitals · Pittsburgh, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390102
Location815 Freeport RoadPittsburgh, PA 15215 · Allegheny County
Emergency services

Upmc Passavant

Acute Care Hospitals · Pittsburgh, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390107
Location9100 Babcock BoulevardPittsburgh, PA 15237 · Allegheny County
Emergency services

Magee Womens Hospital Of Upmc Health System

Acute Care Hospitals · Pittsburgh, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390114
Location300 Halket StreetPittsburgh, PA 15213 · Allegheny County
Emergency services Birthing friendly

Upmc Presbyterian Shadyside

Acute Care Hospitals · Pittsburgh, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390164
Location200 Lothrop StreetPittsburgh, PA 15213 · Allegheny County
Emergency services

Butler Memorial Hospital

Acute Care Hospitals · Butler, PA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390168
LocationOne Hospital WayButler, PA 16001 · Butler County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15090 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

77.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality68.61
Promoting Interoperability100
Improvement Activities40
Cost56.4

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Priya Cardone's NPI number?

The NPI number for Priya Cardone is 1568819720. It was assigned to this individual provider in the NPPES registry on May 18, 2016.

Where is Priya Cardone located?

Priya Cardone practices at 12680 Perry Hwy Dept Of, Wexford, PA 15090. The listed phone number is (412) 748-5543.

What is Priya Cardone's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Priya Cardone enrolled in Medicare?

Yes. Priya Cardone is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Priya Cardone affiliated with any hospitals?

According to CMS data, Priya Cardone is affiliated with Upmc St Margaret, Upmc Passavant, Magee Womens Hospital Of Upmc Health System, Upmc Presbyterian Shadyside and Butler Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Priya Cardone was last updated on November 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.