Individual provider Active NPI

Joshua Watt, PSY. D.

  • Psychologist
  • Johnstown, PA
National Provider Identifier
1164720439
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
865 Eisenhower Blvd.
Johnstown, PA 15904-3327
Phone
(814) 266-8840
Fax
(814) 266-2176
NPI assigned
Mar 10, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PA Primary
Psychologist 103T00000X PS017055 PA

Addresses

Primary practice location

865 Eisenhower Blvd.
Johnstown, PA 15904-3327

Mailing address

1322 Eisenhower Blvd.
Johnstown, PA 15904-3307
Phone (814) 266-8840

Other identifiers 1

IdentifierTypeStateIssuer
1007708200003MedicaidPA

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
I20140520001343 PA Practitioner - Clinical Psychologist 6608099692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Care SpecialistsGroup PAC ID 9537333604, 8 clinicians

Practice addresses (Care Compare)

865 Eisenhower Blvd
Johnstown, PA 15904-3318
Phone (814) 266-8840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Community Pediatrics Past Accepting new patients

Organizations & group practices 2

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": "1299715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314921600000",
    "number": "1164720439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 EISENHOWER BLVD.",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043307",
            "telephone_number": "814-266-8840",
            "fax_number": "814-266-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 EISENHOWER BLVD.",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043327",
            "telephone_number": "814-266-8840",
            "fax_number": "814-266-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATT",
        "first_name": "JOSHUA",
        "credential": "PSY. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-10",
        "last_updated": "2011-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS017055",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007708200003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.