Individual provider Active NPI

Joanne P. Perilstein, PHD

  • Psychologist
  • Philadelphia, PA
National Provider Identifier
1427014281
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS004610L Issued in PA
Practice address
1901 Walnut St
Apt 16F
Philadelphia, PA 19103-4640
Phone
(215) 564-4669
NPI assigned
Apr 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS004610L PA Primary
Counseling Psychologist 103TC1900X PS004610L PA
Health Service Psychologist 103TH0100X PS004610L PA
Rehabilitation Psychologist 103TR0400X PS004610L PA

Addresses

Primary practice location

1901 Walnut St
Apt 16F
Philadelphia, PA 19103-4640

Mailing address

1901 Walnut St
Apt 16F
Philadelphia, PA 19103-4640
Phone (215) 564-4669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080131000429 PA Practitioner - Psychologist Billing Independently 3476635293 Practice locations: Philadelphia, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1901 Walnut St
Philadelphia, PA 19103-4644
Phone (215) 564-4669

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS004610LPAMDRehabilitation Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1427014281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 WALNUT ST",
            "address_2": "APT 16F",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191034640",
            "telephone_number": "215-564-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 WALNUT ST",
            "address_2": "APT 16F",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191034640",
            "telephone_number": "215-564-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERILSTEIN",
        "first_name": "JOANNE",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS004610L",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PA",
            "license": "PS004610L",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "PA",
            "license": "PS004610L",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "PA",
            "license": "PS004610L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.