Individual provider Active NPI

Jenna Pauline Mates

  • Psychologist
  • Pittsburgh, PA
National Provider Identifier
1245767284
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS018924 Issued in PA
Practice address
1326 Freeport Rd Ste 250
Pittsburgh, PA 15238-3121
Phone
(412) 967-0610
NPI assigned
May 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X
Psychologist 103T00000X PS018924 PA Primary

Addresses

Primary practice location

1326 Freeport Rd Ste 250
Pittsburgh, PA 15238-3121

Mailing address

4949 Ellsworth Ave
Pittsburgh, PA 15213-2806
Phone (412) 389-8489

Other practice location 1

1156 N Broadway
Yonkers, NY 10701-1108
Phone (914) 965-3700

Other practice location 2

37 Robb Hollow Rd
Pittsburgh, PA 15243-1717
Phone (412) 344-2194

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
I20191223000287 PA Practitioner - Clinical Psychologist 8729412952 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS018924PAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Mental Health Associates PC CurrentSince Dec 1, 2019 Accepting new patients
Jenna Mates PSYD LLC Psychologist CurrentSince Apr 30, 2023 Accepting new patients

Locations

700 Blaw Ave
Ste 201
Pittsburgh, PA 15238
Phone (412) 820-2400

5850 Ellsworth Ave
Ste 220
Pittsburgh, PA 15232
Phone (412) 389-8489

1326 Freeport Rd
Ste 250
Pittsburgh, PA 15238
Phone (412) 967-5656

Organizations & group practices 2

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": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1245767284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4949 ELLSWORTH AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152132806",
            "telephone_number": "412-389-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1326 FREEPORT RD STE 250",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152383121",
            "telephone_number": "412-967-0610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1156 N Broadway",
            "address_purpose": "LOCATION",
            "city": "Yonkers",
            "state": "NY",
            "postal_code": "107011108",
            "country_code": "US",
            "telephone_number": "914-965-3700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "37 Robb Hollow Rd",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152431717",
            "country_code": "US",
            "telephone_number": "412-344-2194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATES",
        "first_name": "JENNA",
        "middle_name": "PAULINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-22",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS018924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.