Individual provider Active NPI

W. Craig McDermit, PH.D.

  • Psychologist
  • San Francisco, CA
National Provider Identifier
1063479251
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY7251 Issued in CA
Practice address
1855 Hayes St
San Francisco, CA 94117-1219
Phone
(415) 776-9200
NPI assigned
Apr 30, 2006
Sex
Male
Sole proprietor
No

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
Psychologist 103T00000X PSY7251 CA Primary

Addresses

Primary practice location

1855 Hayes St
San Francisco, CA 94117-1219

Mailing address

1855 Hayes St
San Francisco, CA 94117-1219
Phone (415) 776-9200

Other identifiers 1

IdentifierTypeStateIssuer
PP0072510MedicaidCA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151202001024 CA Practitioner - Clinical Psychologist 9739489410 Practice locations: San Francisco, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1855 Hayes St
San Francisco, CA 94117-1219
Phone (415) 776-9200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY7251CAMDPsychologist
7251CAMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
California Pacific Medical Group, Inc. Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063479251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 HAYES ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941171219",
            "telephone_number": "415-776-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 HAYES ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941171219",
            "telephone_number": "415-776-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDERMIT",
        "first_name": "W.",
        "middle_name": "CRAIG",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY7251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PP0072510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.