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PRAMOD PILANIA M.D.
NPI 1699817353
Psychiatry & Neurology - Psychiatry in Philadelphia, PA

Active since February 12, 2007PECOS EnrolledAccepts Medicare Assignment
2927 N 5TH ST, PHILADELPHIA, PA 19133(215) 291-4957(484) 221-9130 Get Directions Write a Review

NPPES record last updated: October 1, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Pramod Pilania M.d. NPPES

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

PRAMOD PILANIA M.D. (NPI 1699817353) is an individual psychiatry provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD427506) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (1997).

NPPES Registry Identity

NPI1699817353
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NamePRAMOD PILANIACredential: M.D.
Location Address2927 N 5TH STPhiladelphia, PA 19133-2800
Mailing Address932 Penn Avenue, 1st FloorWyomissing, PA 19610-3017 · (484) 513-3793 · Fax (484) 509-5122
Phone(215) 291-4957
Fax(484) 221-9130
Sole ProprietorNo
Medical School CMSOtherGraduated 1997
Enumeration DateFebruary 12, 2007
Last NPPES UpdateOctober 1, 2024
NPPES CertifiedOctober 1, 2024
✔ NPI 1699817353 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in PA · MD427506
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
2927 N 5TH ST, Philadelphia, PA 19133
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Secondary Practice Locations 2

Location 138 South 5th StreetReading, PA 19602-1049 · Phone (610) 374-7035 · Fax (610) 374-2508
Location 2932 Penn Ave Fl 1Wyomissing, PA 19610-3017 · Phone (484) 513-3793 · Fax (484) 509-5122

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Pramod Pilania M.d. 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 ID2466460969
PECOS Enrollment IDI20060324000315
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.

Medicare Billing Reassignment

Medicare enrollment records show Pramod Pilania reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Hope Behavioral Health LLC
49 mi
Psychiatry
932 PENN AVE FL 1
Wyomissing, PA 19610
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 6 clinicians in this Medicare group
NPI 1194433888 (484) 513-3793

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

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.
208 services58 patients
Psychotherapy, 1 hour 90837
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.
109 services16 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
88 services40 patients
Psychiatric diagnostic evaluation with medical services 90792
A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
61 services60 patients
Telephone medical discussion with physician, 21-30 minutes 99443
This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.
55 services30 patients
Psychiatric diagnostic evaluation 90791
A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.
17 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19133 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
$180.99 typical visit price
range $59.88 – $180.99
Typical copayment $45.24 (range $14.97 – $45.24)
Most-billed visit code 99205
Established Patient
$74.47 typical visit price
range $19.30 – $147.29
Typical copayment $18.61 (range $4.82 – $36.82)
Most-billed visit code 99213
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.

LORI L REYES BS
Counselor (Mental Health)
2927 N 5TH ST
PHILADELPHIA, PA 19133
Philadelphia County (484) 221-9136
ALTAGRACIA RAMIREZ
Counselor (Mental Health)
2927 N 5TH ST, 2ND FLOOR
PHILADELPHIA, PA 19133
Philadelphia County (484) 221-9136
NORTHEAST COMMUNITY MENTAL HEALTH CENTER, INC.
Clinic/Center (Mental Health (Including Community Mental Health Center))
2927 N 5TH ST, 2ND FLOOR
PHILADELPHIA, PA 19133
Philadelphia County (215) 291-4357
YVAN MARLIN MA
Counselor (Mental Health)
2927 N 5TH ST
PHILADELPHIA, PA 19133
Philadelphia County (484) 221-9136
KEONNA JANEEN MARTIN MS
Counselor
2927 N 5TH ST, SUITE 103
PHILADELPHIA, PA 19133
Philadelphia County (215) 634-6400
DOMINGA PENA BS
Counselor (Mental Health)
2927 N 5TH ST
PHILADELPHIA, PA 19133
Philadelphia County (484) 221-9136
DAVID CUEVAS MA
Counselor (Mental Health)
2927 N 5TH ST
PHILADELPHIA, PA 19133
Philadelphia County (484) 221-9136
NATIVIDAD MELO BA
Counselor (Mental Health)
2927 N 5TH ST
PHILADELPHIA, PA 19133
Philadelphia County (484) 221-9136

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 Pramod Pilania's NPI number?

The NPI number for Pramod Pilania is 1699817353. It was assigned to this individual provider in the NPPES registry on February 12, 2007.

Where is Pramod Pilania located?

Pramod Pilania practices at 2927 N 5th St, Philadelphia, PA 19133. The listed phone number is (215) 291-4957.

What is Pramod Pilania's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Pramod Pilania enrolled in Medicare?

Yes. Pramod Pilania 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.

Which organization bills Medicare for Pramod Pilania's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Pramod Pilania reassigns Medicare benefits to Hope Behavioral Health LLC (Wyomissing, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Pramod Pilania's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Pramod Pilania accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Buckeye Health Plan, AmeriHealth Caritas Next and Blue Cross and Blue Shield of Texas and 2 other insurers list Pramod Pilania as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pramod Pilania was last updated on October 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.