Active NPI
Michael Jason Breus, PHD
- Clinical Psychologist
- Scottsdale, AZ
National Provider Identifier
1215956891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3760
- Practice address
- 9913 N. 95TH St.
Scottsdale, AZ 85258 - Phone
- (480) 860-8998
- Fax
- (480) 377-9245
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3760 | AZ | Primary |
Addresses
Primary practice location
9913 N. 95TH St.
Scottsdale, AZ 85258
Mailing address
9913 N. 95TH St.
Scottsdale, AZ 85258
Phone (480) 860-8998
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3760 | Other | AZ | AZ BOARD OF PSYCHOLOGIST |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353888000000",
"number": "1215956891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9913 N. 95TH ST.",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "85258",
"telephone_number": "480-860-8998",
"fax_number": "480-377-9245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9913 N. 95TH ST.",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "85258",
"telephone_number": "480-860-8998",
"fax_number": "480-377-9245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREUS",
"first_name": "MICHAEL",
"middle_name": "JASON",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2012-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AZ",
"license": "3760",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AZ BOARD OF PSYCHOLOGIST",
"identifier": "3760",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.