POONEH MEMAR ARDESTANI MD, PHD
NPI 1659996064
Psychiatry & Neurology - Neurology in Philadelphia, PA

Q: What is Pooneh Memar Ardestani's NPI number?

The NPI number for Pooneh Memar Ardestani is 1659996064. It was assigned to this individual provider in the NPPES registry on June 11, 2020.

Q: What is Pooneh Memar Ardestani's specialty?

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

Active since June 11, 2020PECOS Enrolled

5501 OLD YORK RD STE 1, PHILADELPHIA, PA 19141(215) 456-7890 Get Directions Write a Review

NPPES record last updated: June 8, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Pooneh Memar Ardestani Md, Phd NPPES

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

POONEH MEMAR ARDESTANI MD, PHD (NPI 1659996064) is an individual neurology provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD486087) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS and maintains a secondary practice location in Philadelphia.

NPPES Registry Identity

NPI1659996064

Entity TypeIndividualFemale

Primary Taxonomy2084N0400X

Provider Legal NamePOONEH MEMAR ARDESTANICredential: MD, PHD

Location Address5501 OLD YORK RD STE 1Philadelphia, PA 19141-3098

Mailing Address5501 Old York Rd Ste 1Philadelphia, PA 19141-3098 · (215) 456-7890

Phone(215) 456-7890

Sole ProprietorNo

Enumeration DateJune 11, 2020

Last NPPES UpdateJune 8, 2026

NPPES CertifiedJune 8, 2026

✔ NPI 1659996064 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 · MD486087

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 ListedInternal MedicineTaxonomy 207R00000X · License MT220203 (PA)

5501 OLD YORK RD STE 1, Philadelphia, PA 19141

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Secondary Practice Location 1

Location 15401 Old York RdPhiladelphia, PA 19141-3030 · Phone (215) 456-7190

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pooneh Memar Ardestani Md, Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19141 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

$137.17 typical visit price

range $59.88 – $180.99

Typical copayment $34.29 (range $14.97 – $45.24)

Most-billed visit code 99204

Established Patient

$105.21 typical visit price

range $19.30 – $147.29

Typical copayment $26.30 (range $4.82 – $36.82)

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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GREGORY JOHNSON MD

Student in an Organized Health Care Education/Training Program