Jeffrey Campodonico, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

3071 Issued in MD

Practice address

120 Sister Pierre Dr
Suite 501
Towson, MD 21204-7516

Phone

(410) 337-6801

Fax

(410) 337-8686

NPI assigned

Jan 18, 2007

Last updated

Jan 24, 2009By the provider in NPPES

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 3

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

Specialty

Clinical Psychologist

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jeffrey R. Campodonico, PH.D., P.a.

  dba NeuroHealth Consulting

  • Clinical Neuropsychologist
  • Towson, MD
  • NPI 1790956118
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232755200000",
    "number": "1407908395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 SISTER PIERRE DR",
            "address_2": "SUITE 501",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047516",
            "telephone_number": "410-598-4966",
            "fax_number": "410-337-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SISTER PIERRE DR",
            "address_2": "SUITE 501",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047516",
            "telephone_number": "410-337-6801",
            "fax_number": "410-337-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPODONICO",
        "first_name": "JEFFREY",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2009-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MD",
            "license": "3071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PREFERRED PROVIDER",
            "identifier": "KEJ2JE",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "403513500",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID NO.",
            "identifier": "706M",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Campbell
• Deborah Ann Campbell, MSN
• Jessica R Campbell
• Krystal Campbell
• Timothy Douglas Campbell, MD
• Janine Canaday, LGPC
• Kelly Marie Canatella, MSN, APRN, FNP-C
• Sofia Candel
• Candoal Healthcare Solutions
• Cheryl Cannon, LCSW-C

• Clinical Neuropsychologist in Towson, MD
• Providers in Towson, MD by specialty
• Clinical Neuropsychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2009; 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.