Individual provider Active NPI

Paul Hiatt, PSY.D.

  • Clinical Psychologist
  • Philadelphia, PA
National Provider Identifier
1437543477
Registry record updated Oct 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS017833 Issued in PA
Practice address
1420 Walnut St 1206
Philadelphia, PA 19102-4012
Phone
(267) 571-9643
Fax
(866) 424-5162
NPI assigned
Mar 27, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS017833 PA Primary

Addresses

Primary practice location

1420 Walnut St 1206
Philadelphia, PA 19102-4012

Mailing address

554E Hewson St
Philadelphia, PA 19125-2435
Phone (267) 571-9643

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
I20151130000109 PA Practitioner - Clinical Psychologist 3870893704 Practice locations: Philadelphia, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1700 Market St
Suite 1005
Philadelphia, PA 19103-3920
Phone (267) 571-9643

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444608000000",
    "number": "1437543477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554E HEWSON ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191252435",
            "telephone_number": "267-571-9643",
            "fax_number": "866-424-5162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 WALNUT ST 1206",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024012",
            "telephone_number": "267-571-9643",
            "fax_number": "866-424-5162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIATT",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-27",
        "last_updated": "2015-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS017833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.