Individual provider Active NPI

Larry P. Montemurro, PH.D.

  • Clinical Psychologist
  • Mt Pleasant, PA
National Provider Identifier
1174689368
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS-00-7237-L Issued in PA
Practice address
902 W Main St
Mt Pleasant, PA 15666-1732
Phone
(724) 423-6217
Fax
(724) 423-1827
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS-00-7237-L PA Primary

Addresses

Primary practice location

902 W Main St
Mt Pleasant, PA 15666-1732

Mailing address

902 W Main St
Mt Pleasant, PA 15666-1732
Phone (724) 423-6217

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
I20140825000028 PA Practitioner - Clinical Psychologist 6406074046 Practice locations: Mt Pleasant, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

902 W Main St
Mt Pleasant, PA 15666-1732
Phone (724) 423-6217

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS-00-7237-LPAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174689368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 W MAIN ST",
            "city": "MT PLEASANT",
            "state": "PA",
            "postal_code": "156661732",
            "telephone_number": "724-423-6217",
            "fax_number": "724-423-1827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 W MAIN ST",
            "city": "MT PLEASANT",
            "state": "PA",
            "postal_code": "156661732",
            "telephone_number": "724-423-6217",
            "fax_number": "724-423-1827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEMURRO",
        "first_name": "LARRY",
        "middle_name": "P.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS-00-7237-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, PA

Sources for this page

Verify at the official NPI Registry.