Emanuel Maidenberg, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY14789 Issued in CA

Practice address

300 Medical PLZ
Los Angeles, CA 90095-0001

Phone

(310) 825-9989

NPI assigned

Jul 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

UC RegentsGroup PAC ID 0749180453, 148 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.32 of 100Reported as group

Quality

76.01

Promoting interoperability

100

Improvement activities

40

Cost

56.17

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• UC Regents

  • Adult Development & Aging Psychologist
  • Los Angeles, CA
  • NPI 1750368999

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1154354694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD",
            "address_2": "SUITE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455632",
            "telephone_number": "310-825-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PLZ",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-825-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIDENBERG",
        "first_name": "EMANUEL",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY14789",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY14789",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY147890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Flavio Pessoa de Melo Maia
• William Maia, RN
• Matthew Maibaum, PHD
• Jesse Barretto Maico
• Eyal Maidan, M.D.
• Karron Maidment, MFT
• Makaela Maier
• Michael Sulu Maiko Jr., LMFT
• Tanya Mailander, MA, LMFT
• Thomas Mailhot, M.D.

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.