Individual provider Active NPI

Eric P Fishman, PH.D.

  • Clinical Neuropsychologist
  • Pittsburgh, PA
National Provider Identifier
1053373142
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Practice address
2702 Tilbury Ave
Pittsburgh, PA 15217-2517
Phone
(304) 281-8442
Fax
(412) 428-9744
NPI assigned
Apr 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X WV612 WV
Specialist 174400000X PS006251L PA
Clinical Neuropsychologist 103G00000X Primary

Addresses

Primary practice location

2702 Tilbury Ave
Pittsburgh, PA 15217-2517

Mailing address

2702 Tilbury Ave
Pittsburgh, PA 15217-2517
Phone (304) 281-8442

Other identifiers 2

IdentifierTypeStateIssuer
001747805OtherWVBLUE CROSS/BLUE SHIELD
612AOtherWVHEALTH PLAN OF UPPER OHIO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, WV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040712000980 PA Practitioner - Clinical Psychologist 5799763173 Practice locations: Pittsburgh, PA
I20120404000769 WV Practitioner - Clinical Psychologist 5799763173 Practice locations: Wheeling, WV

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2702 Tilbury Ave
Pittsburgh, PA 15217-2517
Phone (304) 281-8442

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
612WVMDProfessional Counselor
PS006251LPAMDSpecialist
WV612WVMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1053373142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 TILBURY AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152172517",
            "telephone_number": "304-281-8442",
            "fax_number": "412-428-9744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 TILBURY AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152172517",
            "telephone_number": "304-281-8442",
            "fax_number": "412-428-9744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHMAN",
        "first_name": "ERIC",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WV",
            "license": "WV612",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "PS006251L",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "001747805",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLAN OF UPPER OHIO",
            "identifier": "612A",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.