Individual provider Active NPI

Caleb John Washabaugh, D.O.

  • Psychiatry Physician
  • Danville, PA
National Provider Identifier
1184156580
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
FW0093194 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-9800
Phone
(570) 271-6211
NPI assigned
Apr 3, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X FW0093194 PA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-9800

Mailing address

130 S Bryn Mawr Ave
Main Line Health Psychiatric Assn,Psych Unit
Bryn Mawr, PA 19010-3143
Phone (484) 337-4286

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210805000125 PA Practitioner - Psychiatry 4486924560 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

130 S Bryn Mawr Ave
Main Line Health Psychiatric Assn Psych Uni
Bryn Mawr, PA 19010-3143
Phone (484) 337-4286

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare CurrentSince Jun 13, 2022 Accepting new patients
Upmc Altoona CurrentSince Aug 1, 2021 Accepting new patients
Upmc Altoona CurrentSince Aug 1, 2021 Accepting new patients
Main Line Hospitals, Inc. Past Accepting new patients

Locations

620 Howard Ave
Altoona, PA 16601
Phone (814) 889-2011

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1184156580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 S BRYN MAWR AVE",
            "address_2": "MAIN LINE HEALTH PSYCHIATRIC ASSN,PSYCH UNIT",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103143",
            "telephone_number": "484-337-4286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-271-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHABAUGH",
        "first_name": "CALEB",
        "middle_name": "JOHN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-03",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "FW0093194",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.