DR. SITARA SHANMUGAM PSYD
NPI 1699520866
Clinical Neuropsychologist in Elkins Park, PA

Active since April 22, 2024PECOS EnrolledAccepts Medicare Assignment
60 TOWNSHIP LINE RD, ELKINS PARK, PA 19027(215) 663-6362(215) 663-6234 Get Directions Write a Review

NPPES record last updated: March 31, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 31, 2026, Mar 12, 2026, May 3, 2024 and 1 more (4 updates tracked since 2024).

About Dr. Sitara Shanmugam Psyd NPPES

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

DR. SITARA SHANMUGAM PSYD (NPI 1699520866) is an individual clinical neuropsychologist in Elkins Park, Pennsylvania, licensed in Pennsylvania (PS019849) and active in the NPI registry since April 2024. She is enrolled in Medicare PECOS, maintains a secondary practice location in Philadelphia, and is a graduate of Philadelphia College Of Osteopathic Medicine (2020).

NPPES Registry Identity

NPI1699520866
Entity TypeIndividualFemale
Primary Taxonomy103G00000X
Provider Legal NameDR. SITARA SHANMUGAMCredential: PSYD
Location Address60 TOWNSHIP LINE RDElkins Park, PA 19027-2220
Mailing Address60 Township Line RdElkins Park, PA 19027-2220
Fax(215) 663-6234
Sole ProprietorNo
Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 2020
Enumeration DateApril 22, 2024
Last NPPES UpdateMarch 31, 20264 updates tracked since enumeration
NPPES CertifiedMarch 31, 2026
NPI 1699520866 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License Licensed in PA · PS019849
Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License PS019849 (PA)
60 TOWNSHIP LINE RD, Elkins Park, PA 19027

Secondary Practice Location 1

Location 1255 S 17th StPhiladelphia, PA 19103-6231 · Phone (610) 892-3800

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. Sitara Shanmugam Psyd 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 ID7618318114
PECOS Enrollment IDI20240515002311
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.

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.

Psychiatry & Neurology (Neurology)
60 TOWNSHIP LINE RD, MULTI-SPECIALTY SUITE
ELKINS PARK, PA 19027
Specialist
60 TOWNSHIP LINE RD
ELKINS PARK, PA 19027
Surgery
60 TOWNSHIP LINE RD
ELKINS PARK, PA 19027
Specialist
60 TOWNSHIP LINE RD
ELKINS PARK, PA 19027
Internal Medicine
60 TOWNSHIP LINE RD
ELKINS PARK, PA 19027
Physician Assistant (Medical)
60 TOWNSHIP LINE RD
ELKINS PARK, PA 19027
Physical Medicine & Rehabilitation
60 TOWNSHIP LINE RD
ELKINS PARK, PA 19027
Physical Medicine & Rehabilitation
60 TOWNSHIP LINE RD
ELKINS PARK, PA 19027

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1699520866, enumerated as an "individual" on April 22, 2024.

The provider is located at 60 TOWNSHIP LINE RD ELKINS PARK, PA 19027 and the phone number is (215) 663-6362.

Clinical Neuropsychologist with taxonomy code 103G00000X.