Individual provider Active NPI

Jennifer Baumgartner Royse, PSYD

  • Clinical Psychologist
  • Pittsburgh, PA
National Provider Identifier
1053459180
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
017985-1 Issued in NY
Practice address
University Drive C
Pittsburgh, PA 15240
Phone
(814) 207-8587
NPI assigned
Feb 1, 2007
Last updated
Dec 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Clinical Psychologist 103TC0700X 04631 MD
Clinical Psychologist 103TC0700X 017985-1 NY Primary

Addresses

Primary practice location

University Drive C
Pittsburgh, PA 15240

Mailing address

200 Somerset Dr
Centre Hall, PA 16828-7820
Phone (301) 706-9087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20120621000135 MD Practitioner - Clinical Psychologist 9032373188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elm Psychological and Coaching ServicesGroup PAC ID 1153710389, 3 clinicians

Practice addresses (Care Compare)

1400 Front Ave
Suite 305
Lutherville, MD 21093-5364
Phone (410) 734-2978

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04631MDMDClinical Psychologist
017985-1NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Elm Psychological and Coaching Services Clinical CurrentSince Feb 1, 2026 Accepting new patients

Locations

1400 Front Ave
Ste 305
Timonium, MD 21093
Phone (410) 696-5013

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1053459180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SOMERSET DR",
            "city": "CENTRE HALL",
            "state": "PA",
            "postal_code": "168287820",
            "telephone_number": "301-706-9087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY DRIVE C",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15240",
            "telephone_number": "814-207-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYSE",
        "first_name": "JENNIFER",
        "middle_name": "BAUMGARTNER",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04631",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "017985-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.