Holly Leigh Edge-Booth, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY20955 Issued in CA

Practice address

200 E del Mar Blvd
Suite 210
Pasadena, CA 91105-2544

Phone

(626) 818-2748

NPI assigned

Nov 15, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Clinical Psychologist

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Neurology Medical Group, Inc.Group PAC ID 5294997854, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

80.62 of 100Reported as group

Quality

49.82

Improvement activities

40

Cost

74.55

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: hollyedge-booth@scnc.allscriptsdirect.net

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.

• Southern California Neurology Medical Group, Inc.

  • Neurology Physician
  • Pasadena, CA
  • NPI 1639461825
  Medicare reassignment Care Compare group
• Lydia S Glass PHD Psychological & Mediation Services Inc

  • Mental Health Counselor
  • Pasadena, CA
  • NPI 1861635013
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144393778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E DEL MAR BLVD",
            "address_2": "SUITE 210",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052544",
            "telephone_number": "626-818-2748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E DEL MAR BLVD",
            "address_2": "SUITE 210",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052544",
            "telephone_number": "626-818-2748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGE-BOOTH",
        "first_name": "HOLLY",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY20955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Edano
• Fatima Eddahbi
• Kalman J Edelman, M.D.
• Opeyemi Edgal
• Deborah Boatwright Edgar, MFT
• Edico Health Care Corporation (EDICO Pain Management and Rehabilitation Wellness Clinic)
• Brittany Edinger
• Edmed Home Health Inc
• Walter Allan Edmiston Jr., MD
• Ilar Karisma Edun, MSW, ACSW

• Clinical Neuropsychologist in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.