Individual provider Active NPI

Susan Troutner

  • Clinical Psychologist
  • Erie, PA
National Provider Identifier
1053861856
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS018135 Issued in PA
Practice address
120 E 2ND St
Third Floor
Erie, PA 16507-1537
Phone
(814) 877-8013
Fax
(814) 877-8007
NPI assigned
Oct 5, 2016
Last updated
Oct 5, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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 PS018135 PA Primary

Addresses

Primary practice location

120 E 2ND St
Third Floor
Erie, PA 16507-1537

Mailing address

120 E 2ND St
Third Floor
Erie, PA 16507-1537
Phone (814) 877-8013

Other identifiers 1

IdentifierTypeStateIssuer
PS 018135OtherPAPA LICENSE NUMBER

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
I20161212000236 PA Practitioner - Clinical Psychologist 4688954548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northshore Psychological Associates, LLCGroup PAC ID 0244133981, 14 clinicians

Practice addresses (Care Compare)

120 E 2ND St
Third Floor
Erie, PA 16507-1578
Phone (814) 877-8013

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northshore Psychological Associates, LLC CurrentSince Oct 1, 2016 Accepting new patients

Locations

120 E 2nd St
Fl 3
Erie, PA 16507
Phone (814) 877-4600

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1053861856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E 2ND ST",
            "address_2": "THIRD FLOOR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071537",
            "telephone_number": "814-877-8013",
            "fax_number": "814-877-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E 2ND ST",
            "address_2": "THIRD FLOOR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071537",
            "telephone_number": "814-877-8013",
            "fax_number": "814-877-8007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROUTNER",
        "first_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-05",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS018135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE NUMBER",
            "identifier": "PS 018135",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.