Individual provider Active NPI

Jaris Stern, PH.D.

  • Psychologist
  • Columbus, OH
National Provider Identifier
1063548576
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
959 Issued in OH
Practice address
6495 E Broad St
Suite C
Columbus, OH 43213-1541
Phone
(614) 322-9760
Fax
(614) 322-9762
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 959 OH Primary

Addresses

Primary practice location

6495 E Broad St
Suite C
Columbus, OH 43213-1541

Mailing address

7641 Alpath Road
New Albany, OH 43054-9268
Phone (614) 218-4071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20170324001739 OH Practitioner - Clinical Psychologist 2264716182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Ohio State University College of Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Access Behavioral LLCGroup PAC ID 1052595402, 23 clinicians

Practice addresses (Care Compare)

2611 Wayne Ave
Dayton, OH 45420-1833
Phone (937) 228-0579

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
959OHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Access Behavioral LLC Psychologist CurrentSince Feb 21, 2017 Accepting new patients
Columbus Center for Behavior and Learning Psychologist Past Accepting new patients

Locations

6400 E Broad St
Fl 4
Columbus, OH 43213
Phone (614) 655-3345

6400 E Broad St
Ste 400
Columbus, OH 43213
Phone (614) 367-7700

2611 Wayne Ave
Dayton, OH 45420
Phone (937) 228-0579

2611 Wayne Ave
Bldg 61
Dayton, OH 45420
Phone (937) 228-0579

Organizations & group practices 2

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1063548576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7641 ALPATH ROAD",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430549268",
            "telephone_number": "614-218-4071",
            "fax_number": "614-218-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6495 E BROAD ST",
            "address_2": "SUITE C",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432131541",
            "telephone_number": "614-322-9760",
            "fax_number": "614-322-9762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "JARIS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.