Sander Jay Kornblith, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS003630L Issued in PA

Practice address

700 Blaw Ave Ste 201
Pittsburgh, PA 15238-3216

Phone

(412) 967-0610

Fax

(412) 968-0527

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Psychologist

Education

University of Pittsburgh School of Medicine, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

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 and National Provider Directory roles.

• Allegheny Mental Health Associates PC

  • Social Worker
  • Pittsburgh, PA
  • NPI 1912001082
  NPD

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1467546705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 BLAW AVE STE 201",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152383216",
            "telephone_number": "412-559-4364",
            "fax_number": "412-968-0527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 BLAW AVE STE 201",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152383216",
            "telephone_number": "412-967-0610",
            "fax_number": "412-968-0527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNBLITH",
        "first_name": "SANDER",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS003630L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "034250",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dimitrios Korentzelos, MD
• Samantha Dawn Kormanik, MA,, LPC
• Robert L Kormos, MD
• Lauren Korn
• Tara Korn
• Rachel Kornfield Becker, MSW, LCSW
• Mahawa Koroma
• Heather Faith Korpa, LCSW
• Alexandra Korshin
• Leah Marie Korte, PHARMD

• Clinical Psychologist in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.