Individual provider Active NPI

Samuel Hubley, PH.D.

  • Clinical Psychologist
  • Aurora, CO
National Provider Identifier
1205222148
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY.0004211 Issued in CO
Practice address
13199 E Montview Blvd Ste 330
Aurora, CO 80045-7209
Phone
(518) 396-6034
NPI assigned
Apr 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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 PSY.0004211 CO Primary

Addresses

Primary practice location

13199 E Montview Blvd Ste 330
Aurora, CO 80045-7209

Mailing address

13199 E Montview Blvd Ste 330
Aurora, CO 80045-7209
Phone (518) 396-6034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY.0004211COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians Incorporated PastSince Dec 1, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1205222148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13199 E MONTVIEW BLVD STE 330",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457209",
            "telephone_number": "518-396-6034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13199 E MONTVIEW BLVD STE 330",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457209",
            "telephone_number": "518-396-6034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBLEY",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-07",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0004211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.