DR. SITARA SHANMUGAM (PSYD) – Clinical Neuropsychologist, NPI 1699520866

DR. SITARA SHANMUGAM (PSYD) is a healthcare provider. based in Philadelphia, Pennsylvania. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSYD. They hold a License No. PS019849 (PA). The NPI Number for DR. SITARA SHANMUGAM (PSYD) is 1699520866

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
DR. SITARA SHANMUGAM (PSYD)
NPI
1699520866
Phone
(610) 892-3800
Address
255 S 17th St
Enumeration Date
22 April 2024
Last Update Date
31 March 2026

Doctor Profile

Medical School Name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
2156636000
Graduation Year
2020 (6 years ago)
PAC ID
7618318114
Group Practice PAC ID
3971412297
Professional Enrollment ID
I20240515002311
Address ID
PA190272220EL60XXXRDXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness85
Years active:2State licenses:1Digital endpointsOther names

1,669 CLINICAL PSYCHOLOGIST in PA

Provider Addresses for DR. SITARA SHANMUGAM (PSYD)

  • 255 S 17th St

    Philadelphia, PA 191036231

    Phone: (610) 892-3800

    Type: Location

  • 60 TOWNSHIP LINE RD

    ELKINS PARK, PA 190272220

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-05-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240515002311IClinical PsychologistPATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 19103)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3971412297View full group profile
NameSpecialtyState
Clinical PsychologistPA
-PA
Clinical PsychologistPA
Clinical PsychologistPA

Reviews

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Frequently asked questions

Can I use this page to confirm DR. SITARA SHANMUGAM (PSYD)'s NPI?
Yes. DR. SITARA SHANMUGAM (PSYD) is listed with NPI 1699520866 in the public NPI dataset.
Can I rely on DR. SITARA SHANMUGAM (PSYD) being an active provider?
As of the registry snapshot, DR. SITARA SHANMUGAM (PSYD) is marked active.
What taxonomy line describes DR. SITARA SHANMUGAM (PSYD)?
For research purposes, treat DR. SITARA SHANMUGAM (PSYD) as Clinical Neuropsychologist in this dataset. Clinical services aligned with this taxonomy classification.
Where is DR. SITARA SHANMUGAM (PSYD) based?
DR. SITARA SHANMUGAM (PSYD) is tied to Philadelphia, Pennsylvania in the data we show; additional addresses may exist on the full record.
Why does DR. SITARA SHANMUGAM (PSYD) have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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