Individual provider Active NPI

Anthony C. Tzoumas, PHD

  • Counseling Psychologist
  • Wyomissing, PA
National Provider Identifier
1265525323
Registry record updated Feb 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PS015292 Issued in PA
Practice address
2201 Ridgewood Road
Suite 400
Wyomissing, PA 19610-6977
Phone
(610) 378-9601
Fax
(610) 378-3610
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2011

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PS015292 PA
Cognitive & Behavioral Psychologist 103TB0200X
Counseling Psychologist 103TC1900X PS015292 PA Primary
Clinical Child & Adolescent Psychologist 103TC2200X PS015292 PA
Intellectual & Developmental Disabilities Psychologist 103TM1800X PS015292 PA

Addresses

Primary practice location

2201 Ridgewood Road
Suite 400
Wyomissing, PA 19610-6977

Mailing address

2201 Ridgewood Road
Suite 400
Wyomissing, PA 19610-6977
Phone (610) 378-9601

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
I20041006000875 PA Practitioner - Clinical Psychologist 7911966874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
DGR Management Inc.Group PAC ID 0941398184, 16 clinicians

Practice addresses (Care Compare)

2201 Ridgewood Rd
Suite 400
Wyomissing, PA 19610-1193
Phone (610) 378-9601

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS015292PAMDIntellectual & Developmental Disabilities Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
DGR Management Inc. CurrentSince Jul 1, 2007 Accepting new patients
Tower Health Medical Group Past Accepting new patients

Locations

2201 Ridgewood Rd
Ste 400
Wyomissing, PA 19610
Phone (610) 378-9601

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296777600000",
    "number": "1265525323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 RIDGEWOOD ROAD",
            "address_2": "SUITE 400",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196106977",
            "telephone_number": "610-378-9601",
            "fax_number": "610-378-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 RIDGEWOOD ROAD",
            "address_2": "SUITE 400",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196106977",
            "telephone_number": "610-378-9601",
            "fax_number": "610-378-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TZOUMAS",
        "first_name": "ANTHONY",
        "middle_name": "C.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2011-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "PA",
            "license": "PS015292",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PA",
            "license": "PS015292",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PA",
            "license": "PS015292",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "PA",
            "license": "PS015292",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.