Individual provider Active NPI

Alexander Jaffe

  • Mental Health Counselor
  • Philadelphia, PA
National Provider Identifier
1346723962
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
9815 Roosevelt Blvd
Philadelphia, PA 19114-1035
Phone
(610) 644-6464
NPI assigned
Sep 10, 2018
Last updated
Sep 10, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

9815 Roosevelt Blvd
Philadelphia, PA 19114-1035

Mailing address

680 American Ave
King of Prussia, PA 19406-4023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20241118001328 FL Practitioner - Clinical Psychologist 7012441777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Psychology, PAGroup PAC ID 0840287991, 8 clinicians

Practice addresses (Care Compare)

12499 Brantley Commons CT
Suite 101
Fort Myers, FL 33907-5694
Phone (239) 278-3443

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Psychology, PA CurrentSince Nov 6, 2024 Accepting new patients

Locations

12499 Brantley Commons Ct
Fort Myers, FL 33907
Phone (239) 278-3443

12499 Brantley Commons Ct
Ste 101
Fort Myers, FL 33907
Phone (239) 278-3443

5621 Strand Blvd
Ste 201
Naples, FL 34110

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": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1346723962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 AMERICAN AVE",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194064023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9815 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141035",
            "telephone_number": "610-644-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFFE",
        "first_name": "ALEXANDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-10",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.