Individual provider Active NPI

Alexandria Diguiseppe, PSY.D

  • Clinical Psychologist
  • Newtown Square, PA
National Provider Identifier
1356070668
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS020204 Issued in PA
Practice address
3855 W Chester Pike Ste 300
Newtown Square, PA 19073-2304
Phone
(888) 227-3898
NPI assigned
Jun 10, 2022
Last updated
Aug 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X PS020204 PA Primary

Addresses

Primary practice location

3855 W Chester Pike Ste 300
Newtown Square, PA 19073-2304

Mailing address

135 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3129

Other practice location 1

135 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3129
Phone (610) 325-1390

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL N/A

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
I20240820001314 PA Practitioner - Clinical Psychologist 3274071394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Philadelphia College of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

3855 W Chester Pike
Newton Square, PA 19073-2304

830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS020204PAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Psychologist CurrentSince Sep 30, 2024 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

3855 West Chester Pike
Ste 300
Newtown Square, PA 19073
Phone (484) 337-2585

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

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": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1356070668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S BRYN MAWR AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 W CHESTER PIKE STE 300",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732304",
            "telephone_number": "888-227-3898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "135 S Bryn Mawr Ave",
            "address_purpose": "LOCATION",
            "city": "Bryn Mawr",
            "state": "PA",
            "postal_code": "190103129",
            "country_code": "US",
            "telephone_number": "610-325-1390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIGUISEPPE",
        "first_name": "ALEXANDRIA",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS020204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "135 S Bryn Mawr Ave",
            "city": "Bryn Mawr",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190103129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newtown Square, PA

Sources for this page

Verify at the official NPI Registry.