Active NPI
Maria Rallis, PH.D.
- Psychologist
- Erie, PA
National Provider Identifier
1255436770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS0088804L
- Practice address
- 3800 West 12TH
Erie, PA 16505 - Phone
- (814) 835-7043
- Fax
- (814) 838-2925
- NPI assigned
- Sep 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS-008804-L | PA | |
| Psychologist | 103T00000X | PS0088804L | PA | Primary |
Addresses
Primary practice location
3800 West 12TH
Erie, PA 16505
Mailing address
3800 West 12TH
Erie, PA 16505
Phone (814) 835-7043
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120221000197 | PA | Practitioner - Clinical Psychologist | 5395903462 | Practice locations: Erie, PA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1213 W 38TH St
Erie, PA 16508-2459
Phone (814) 384-7985
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS0088804L | PA | MD | Psychologist |
| PS-008804-L | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330992000000",
"number": "1255436770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3800 WEST 12TH",
"city": "ERIE",
"state": "PA",
"postal_code": "16505",
"telephone_number": "814-835-7043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 WEST 12TH",
"city": "ERIE",
"state": "PA",
"postal_code": "16505",
"telephone_number": "814-835-7043",
"fax_number": "814-838-2925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RALLIS",
"first_name": "MARIA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-13",
"last_updated": "2012-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS-008804-L",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS0088804L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.