Individual provider Active NPI

Paul Christopher Coburn, PH.D.

  • Clinical Psychologist
  • Pittsburgh, PA
National Provider Identifier
1033120720
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS00418-L Issued in PA
Practice address
1326 Freeport Rd
Suite 250
Pittsburgh, PA 15238-3131
Phone
(412) 967-5656
NPI assigned
Aug 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS00418-L PA Primary

Addresses

Primary practice location

1326 Freeport Rd
Suite 250
Pittsburgh, PA 15238-3131

Mailing address

713 W Waldheim Rd
Pittsburgh, PA 15215-1807
Phone (412) 782-2966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120426000258 PA Practitioner - Clinical Psychologist 7618919184 Practice locations: Pittsburgh, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

700 Blaw Ave
Suite 201
Pittsburgh, PA 15238-3216
Phone (412) 967-0610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS00418-LPAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Mental Health Associates PC PastSince Sep 26, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033120720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 W WALDHEIM RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152151807",
            "telephone_number": "412-782-2966",
            "fax_number": "412-968-0527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1326 FREEPORT RD",
            "address_2": "SUITE 250",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152383131",
            "telephone_number": "412-967-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBURN",
        "first_name": "PAUL",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS00418-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.