Individual provider Active NPI

Jamie Vanartsdalen, PSYD

  • Clinical Neuropsychologist
  • Berwyn, PA
National Provider Identifier
1114620465
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PS019818 Issued in PA
Practice address
1199 Lancaster Ave Ste 110
Berwyn, PA 19312-1341
Phone
(610) 241-4331
NPI assigned
Mar 24, 2023
Last updated
Mar 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PS019818 PA Primary

Addresses

Primary practice location

1199 Lancaster Ave Ste 110
Berwyn, PA 19312-1341

Mailing address

1199 Lancaster Ave Ste 110
Berwyn, PA 19312-1341
Phone (610) 241-4331

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
I20230407001680 PA Practitioner - Clinical Psychologist 7517332372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neuropsychological Assessment and Therapy Services LLCGroup PAC ID 0648577361, 4 clinicians

Practice addresses (Care Compare)

1199 Lancaster Ave
Suite 110
Berwyn, PA 19312-1341
Phone (610) 241-4331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Neuropsychological Assessment and Therapy Services, LLC Clinical Neuropsychologist CurrentSince Mar 1, 2023 Accepting new patients

Locations

1199 Lancaster Ave
Ste 105
Berwyn, PA 19312
Phone (610) 241-4331

1199 Lancaster Ave
Ste 110
Berwyn, PA 19312
Phone (610) 241-4331

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1114620465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1199 LANCASTER AVE STE 110",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193121341",
            "telephone_number": "610-241-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 LANCASTER AVE STE 110",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193121341",
            "telephone_number": "610-241-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANARTSDALEN",
        "first_name": "JAMIE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-24",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "PA",
            "license": "PS019818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, PA

Sources for this page

Verify at the official NPI Registry.