Active NPI
John B Carmody, PHD.
- Clinical Psychologist
- San Francisco, CA
National Provider Identifier
1053524561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 9720
- Practice address
- 20 Parker Ave
Apt 1
San Francisco, CA 94118-2636 - Phone
- (415) 386-5944
- NPI assigned
- May 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 9720 | CA | Primary |
Addresses
Primary practice location
20 Parker Ave
Apt 1
San Francisco, CA 94118-2636
Mailing address
20 Parker Ave
Apt 1
San Francisco, CA 94118-2636
Phone (415) 386-5944
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120410000156 | CA | Practitioner - Clinical Psychologist | 8426219908 | Practice locations: San Francisco, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
20 Parker Ave
Apt 1
San Francisco, CA 94118-2636
Phone (415) 386-5944
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 9720 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607644800000",
"number": "1053524561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 PARKER AVE",
"address_2": "APT 1",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941182636",
"telephone_number": "415-386-5944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 PARKER AVE",
"address_2": "APT 1",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941182636",
"telephone_number": "415-386-5944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARMODY",
"first_name": "JOHN",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "PHD.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-08",
"last_updated": "2020-12-11",
"certification_date": "2020-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 9720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.