Patricia K Masuda-Story, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY20385 Issued in CA

Practice address

100 N Brand Blvd
Suite 316
Glendale, CA 91203-2641

Phone

(818) 561-0531

Fax

(800) 976-0803

NPI assigned

Jun 4, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Other identifiers 6

Other names 1

• Dr. Patricia Keiko Masuda-Story Other name

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

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 2

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Atomic Shrink Psychology, Inc

  • Clinical Psychologist
  • Big Bear Lake, CA
  • NPI 1770922817
  Medicare reassignment NPD Authorized official
• Vericare of California Medical Group

  • Clinical Psychologist
  • Paradise, CA
  • NPI 1316992829
  NPD (past)
• Asana Integrated Medical Group PC

  • Psychiatry Physician
  • Sioux Falls, SD
  • NPI 1396783379

  Clinical

  NPD (past)

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472860800000",
    "number": "1467490987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17328 VENTURA BLVD",
            "address_2": "#134",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163904",
            "telephone_number": "818-561-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N BRAND BLVD",
            "address_2": "SUITE 316",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032641",
            "telephone_number": "818-561-0531",
            "fax_number": "800-976-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASUDA-STORY",
        "first_name": "PATRICIA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2016-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY20385",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY2973",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY20385",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY20385",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "CA",
            "license": "PSY 20385",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "CA",
            "license": "PSY 20385",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2287027",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLLEGE HEALTH IPA",
            "identifier": "12006",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0PL203850",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "2191850",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9357265",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY203850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "MASUDA-STORY",
            "middle_name": "KEIKO",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinical Psychologist in Glendale, CA
• Providers in Glendale, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2016; 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.