Jonathan P Vitriol, PSYD
Individual provider Active NPI Psychologist · Feasterville, PA
NPI 1194765016 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1194765016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- PS003972L (PA)
- Practice address
- 1016 Mill Creek Dr
Feasterville, PA 19053 - Phone
- (215) 396-9966
- NPI assigned
- Jun 8, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1016 Mill Creek Dr
Feasterville, PA 19053-7383
1016 Millcreek Dr
Feasterville Trevose, PA 19053-7383
Phone (215) 396-9966
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150506000200 | PA | Practitioner - Clinical Psychologist | 3072832401 | Practice locations: Feasterville, PA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 355100362300 | NJ | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS003972L | PA | Yes |
| Psychologist | 103T00000X | 355100362300 | NJ |
Addresses
Primary practice location
1016 Mill Creek Dr
Feasterville, PA 19053
Mailing address
1016 Mill Creek Dr
Feasterville, PA 19053
Phone (215) 396-9966
Other providers in Feasterville, PA
- Sma Medical, Inc.
- Joseph Terragrossa
- Thomas Duffield, MD, PC
- TLC Hospice Inc
- United Therapy Centers, Inc.
- Jared Scott Weiner
- Welcome Ambulance Inc.
- Young Enterprises
All providers in Feasterville, PA · Psychologist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.