Individual provider Active NPI

Steven K Diehl, PHD

  • Psychologist
  • Middletown, RI
National Provider Identifier
1215988175
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS00851 Issued in RI
Practice address
850 Aquidneck Ave
Middletown, RI 02842-7244
Phone
(401) 440-7927
Fax
(401) 842-0360
NPI assigned
May 15, 2006
Last updated
Jul 22, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS00851 RI Primary

Addresses

Primary practice location

850 Aquidneck Ave
Middletown, RI 02842-7244

Mailing address

39 Toledo Ave
Pawtucket, RI 02860-4727
Phone (401) 440-7927

Other identifiers 6

IdentifierTypeStateIssuer
291415OtherRIBCBS
412175OtherRIBCHIP
SD32151MedicaidRI
10301100OtherRINHP
411814OtherRIMEDICARE GROUP NUMBER
SD32151OtherRIHARVARD PILGRIM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20051201000461 RI Practitioner - Clinical Psychologist 7214985779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Community Health CareGroup PAC ID 1355250663, 35 clinicians

Practice addresses (Care Compare)

PO Box
Pascoag, RI 02859

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS00851RIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Community Health Care CurrentSince May 1, 2017 Accepting new patients
Northwest Community Health Care CurrentSince May 1, 2017 Accepting new patients
Northwest Community Health Care Current Accepting new patients
Maxim Healthcare Services Inc Past Accepting new patients
Nickerson Community Center Past Accepting new patients

Locations

36 Bridge Way
Pascoag, RI 02859
Phone (401) 567-0800

Organizations & group practices 5

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216684800000",
    "number": "1215988175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 TOLEDO AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604727",
            "telephone_number": "401-440-7927",
            "fax_number": "401-842-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 AQUIDNECK AVE",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028427244",
            "telephone_number": "401-440-7927",
            "fax_number": "401-842-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEHL",
        "first_name": "STEVEN",
        "middle_name": "K",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2008-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "RI",
            "license": "PS00851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "291415",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCHIP",
            "identifier": "412175",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD32151",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "10301100",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "411814",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "SD32151",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, RI

Sources for this page

Verify at the official NPI Registry.