Individual provider Active NPI

Peter F Fischbeck, LCSW

  • Clinical Social Worker
  • Bryn Mawr, PA
National Provider Identifier
1194310219
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW021504 Issued in PA
Practice address
850 W Lancaster Ave Ste 2
Bryn Mawr, PA 19010-3220
Phone
(610) 520-1510
Fax
(610) 520-1016
NPI assigned
Mar 2, 2021
Last updated
Mar 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW021504 PA Primary

Addresses

Primary practice location

850 W Lancaster Ave Ste 2
Bryn Mawr, PA 19010-3220

Mailing address

850 W Lancaster Ave Ste 2
Bryn Mawr, PA 19010-3220
Phone (610) 520-1510

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
I20210310000954 PA Practitioner - Clinical Social Worker 9638585045 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sayre Health CenterGroup PAC ID 7416955000, 6 clinicians

Practice addresses (Care Compare)

5800 Walnut St
Rear
Philadelphia, PA 19139-3836
Phone (215) 474-4444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice & Counseling Services Network, Inc. CurrentSince Mar 8, 2021 Accepting new patients
Resources for Human Development, Inc. Current Accepting new patients
Family Practice & Counseling Services Network, Inc. CurrentSince Mar 8, 2021 Accepting new patients
Sayre Health Center CurrentSince Sep 30, 2024 Accepting new patients

Locations

850 W Lancaster Ave
Ste 2
Bryn Mawr, PA 19010
Phone (484) 383-0038

2300 W Master St
Philadelphia, PA 19121
Phone (267) 687-1172

4700 Wissahickon Ave
Bldg D
Philadelphia, PA 19144
Phone (215) 843-9720

5800 Walnut St
Rear
Philadelphia, PA 19139
Phone (215) 474-4444

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73304
  • FHIR API: https://fhir4.healow.com/fhir/r4/CHJCDD

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, 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": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1194310219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W LANCASTER AVE STE 2",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103220",
            "telephone_number": "610-520-1510",
            "fax_number": "610-520-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W LANCASTER AVE STE 2",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103220",
            "telephone_number": "610-520-1510",
            "fax_number": "610-520-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHBECK",
        "first_name": "PETER",
        "middle_name": "F",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW021504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.