Individual provider Active NPI

Bruce Alan Merhige, PHD

  • Clinical Psychologist
  • Philadelphia, PA
National Provider Identifier
1093864431
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS002100L Issued in PA
Practice address
255 S 17TH Street
Suite 1707
Philadelphia, PA 19103-6217
Phone
(215) 546-2556
Fax
(215) 546-2556
NPI assigned
Jan 8, 2007
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
Clinical Psychologist 103TC0700X PS002100L PA Primary

Addresses

Primary practice location

255 S 17TH Street
Suite 1707
Philadelphia, PA 19103-6217

Mailing address

255 S 17TH Street
Suite 1707
Philadelphia, PA 19103-6217
Phone (215) 546-2556

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
I20120315000220 PA Practitioner - Clinical Psychologist 9133388853 Practice locations: Philadelphia, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

255 S 17TH St
Suite 1707
Philadelphia, PA 19103-6217
Phone (215) 546-2556

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS002100LPAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093864431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 S 17TH STREET",
            "address_2": "SUITE 1707",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036217",
            "telephone_number": "215-546-2556",
            "fax_number": "215-546-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S 17TH STREET",
            "address_2": "SUITE 1707",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036217",
            "telephone_number": "215-546-2556",
            "fax_number": "215-546-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERHIGE",
        "first_name": "BRUCE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS002100L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.