Individual provider Active NPI

John Franklin Beltramo, PSY.D.

  • Clinical Psychologist
  • Highwood, IL
National Provider Identifier
1184778748
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071007099 Issued in IL
Practice address
243 Everts PL
Highwood, IL 60040-1717
Phone
(847) 571-4105
NPI assigned
Jan 22, 2007
Last updated
Mar 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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 071007099 IL Primary

Addresses

Primary practice location

243 Everts PL
Highwood, IL 60040-1717

Mailing address

243 Everts PL
Highwood, IL 60040-1717
Phone (847) 571-4105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20131213000653 IL Practitioner - Clinical Psychologist 0244467413 Practice locations: Highwood, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

243 Everts PL
Highwood, IL 60040-1717
Phone (847) 571-4105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071007099ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Family Stress Clinic Past Accepting new patients
PHC of Buffalo Grove Nutrition Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.victoriabeltramo@146897.advancedmd-direct.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1184778748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 EVERTS PL",
            "city": "HIGHWOOD",
            "state": "IL",
            "postal_code": "600401717",
            "telephone_number": "847-571-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 EVERTS PL",
            "city": "HIGHWOOD",
            "state": "IL",
            "postal_code": "600401717",
            "telephone_number": "847-571-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELTRAMO",
        "first_name": "JOHN",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highwood, IL

Sources for this page

Verify at the official NPI Registry.