Devin Edward Prouty, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY2597 Issued in CA

Practice address

845 El Camino Real
Menlo Park, CA 94025-4807

Phone

(650) 762-8352

NPI assigned

Aug 4, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment Care Compare group NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Redwood City, CA
  • NPI 1639252604
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Behavioral Health Care, Inc.

  • Counseling Psychologist
  • Santa Cruz, CA
  • NPI 1942372123
  NPD (past)
• Pacific Anxiety Group

  • Cognitive & Behavioral Psychologist
  • Menlo Park, CA
  • NPI 1144562828
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1285948950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 RAVENSWOOD AVE",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940253453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 EL CAMINO REAL",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254807",
            "telephone_number": "650-762-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROUTY",
        "first_name": "DEVIN",
        "middle_name": "EDWARD",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-04",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY2597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGY LICENCE",
            "identifier": "PSY25979",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Preuss Pharmacy
• Martha Gail Price, PH.D.
• Ayonna Procter, DPT
• Luciana Christina Profaca, PHD
• Progressive Radiology Services
• Melissa Anne Puckett, MS
• Sandra Ann Pursell, PH.D.
• Jonathan Purtell
• Anthony Quach
• Susan Elizabeth Quaglietti

• Clinical Psychologist in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.

Verify at the official NPI Registry.