Individual provider Active NPI

Kami Marchese, PSY.D.

  • Clinical Neuropsychologist
  • King of Prussia, PA
National Provider Identifier
1104020650
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PS016241 Issued in PA
Practice address
622 Summit St
King of Prussia, PA 19406-2720
Phone
(610) 272-2356
NPI assigned
Jun 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS016241 PA
Clinical Neuropsychologist 103G00000X PS016241 PA Primary

Addresses

Primary practice location

622 Summit St
King of Prussia, PA 19406-2720

Mailing address

670 Woodbourne Rd
Ste 302
Langhorne, PA 19047-1834
Phone (215) 750-5525

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
I20070705000172 PA Practitioner - Clinical Psychologist 3476653494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

414 Paoli Pike
Malvern, PA 19355-3311
Phone (484) 596-5430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS016241PAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Psychological PC CurrentSince Dec 16, 2020 Accepting new patients
Main Line Healthcare Psychologist CurrentSince Mar 21, 2022 Accepting new patients
The Neuropsychology Assessment Center at Widener University Past Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

1020 Baltimore Pike
Ste 210
Glen Mills, PA 19342
Phone (484) 227-7777

491 Allendale Rd
Ste 322
Kng of Prussa, PA 19406
Phone (215) 805-4092

414 Paoli Pike
Malvern, PA 19355
Phone (484) 596-5254

1489 Baltimore Pike
Ste 250
Springfield, PA 19064
Phone 6105442110144

Organizations & group practices 3

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": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1104020650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 WOODBOURNE RD",
            "address_2": "STE 302",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471834",
            "telephone_number": "215-750-5525",
            "fax_number": "215-750-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 SUMMIT ST",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062720",
            "telephone_number": "610-272-2356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCHESE",
        "first_name": "KAMI",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS016241",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "PA",
            "license": "PS016241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King of Prussia, PA

Sources for this page

Verify at the official NPI Registry.