Individual provider Active NPI

Steven David, PH.D.

  • Clinical Psychologist
  • Yarmouth Port, MA
National Provider Identifier
1073762928
Registry record updated Jan 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY22018 Issued in CA
Practice address
143 Route 6a
Yarmouth Port, MA 02675-1713
Phone
(323) 401-0493
Fax
(508) 744-7205
NPI assigned
Sep 16, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY22018 CA
Psychologist 103T00000X PSY22018 CA
Adult Development & Aging Psychologist 103TA0700X PSY22018 CA
Cognitive & Behavioral Psychologist 103TB0200X PSY22018 CA
Clinical Psychologist 103TC0700X PSY22018 CA Primary

Addresses

Primary practice location

143 Route 6a
Yarmouth Port, MA 02675-1713

Mailing address

143 Route 6a
Yarmouth Port, MA 02675-1713
Phone (323) 401-0493

Other identifiers 1

IdentifierTypeStateIssuer
PSY220180MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090602000584 CA Practitioner - Clinical Psychologist 6800946435 Practice locations: Beverly Hills, CA
I20220819000780 MA Practitioner - Clinical Psychologist 6800946435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

143 Route 6a
Yarmouth Port, MA 02675-1713
Phone (323) 401-0493

National Provider Directory

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

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": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674345600000",
    "number": "1073762928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 ROUTE 6A",
            "city": "YARMOUTH PORT",
            "state": "MA",
            "postal_code": "026751713",
            "telephone_number": "323-401-0493",
            "fax_number": "508-744-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 ROUTE 6A",
            "city": "YARMOUTH PORT",
            "state": "MA",
            "postal_code": "026751713",
            "telephone_number": "323-401-0493",
            "fax_number": "508-744-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVID",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-16",
        "last_updated": "2023-01-22",
        "certification_date": "2023-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY22018",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY22018",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "CA",
            "license": "PSY22018",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY22018",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY220180",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yarmouth Port, MA

Sources for this page

Verify at the official NPI Registry.