Individual provider Active NPI

Harvey L Gewanter, PHD

  • Clinical Psychologist
  • Baltimore, MD
National Provider Identifier
1255485546
Registry record updated Feb 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
02663 Issued in MD
Practice address
6918 Ridge Rd
Baltimore, MD 21237-3854
Phone
(410) 764-8209
NPI assigned
Jan 23, 2007
Last updated
Feb 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2013

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 02663 MD Primary

Addresses

Primary practice location

6918 Ridge Rd
Baltimore, MD 21237-3854

Mailing address

6918 Ridge Rd
Baltimore, MD 21237-3854
Phone (410) 764-8209

Other identifiers 1

IdentifierTypeStateIssuer
496300800MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20120210000519 MD Practitioner - Clinical Psychologist 2769649227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2833 Smith Ave
Suite 430
Baltimore, MD 21209-1426
Phone (410) 686-9800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02663MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Harvey L Gewanter PHD and Associates Clinical CurrentSince Sep 1, 1995 Accepting new patients

Locations

2833 Smith Ave
Ste 430
Baltimore, MD 21209
Phone (410) 686-9800

6918 Ridge Rd
Rosedale, MD 21237
Phone (410) 687-4400

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, 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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1255485546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6918 RIDGE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373854",
            "telephone_number": "410-764-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6918 RIDGE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373854",
            "telephone_number": "410-764-8209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEWANTER",
        "first_name": "HARVEY",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "02663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "496300800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.