Robert L Mailliard, PSYCHOLOGIST

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS016253 Issued in PA

Practice address

120 E 2ND St
Third Floor
Erie, PA 16507-1537

Phone

(814) 877-8013

Fax

(814) 877-8007

NPI assigned

Jul 6, 2007

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 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

Philadelphia College of Osteopathic Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northshore Psychological Associates, LLCGroup PAC ID 0244133981, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Upmc Hamot Hospital, Erie, PA, CCN 390063
• Saint Vincent Hospital Hospital, Erie, PA, CCN 390009

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.

• Northshore Psychological Associates, LLC

  • Clinical Neuropsychologist
  • Erie, PA
  • NPI 1891786331
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Vincent Health Center

  • General Acute Care Hospital
  • Erie, PA
  • NPI 1861435042
  Care Compare affiliation
• Upmc Hamot

  • General Acute Care Hospital
  • Erie, PA
  • NPI 1487647590
  Care Compare affiliation
• Upmc Hamot

  • General Acute Care Hospital
  • Erie, PA
  • NPI 1538207394
  Care Compare affiliation

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439942400000",
    "number": "1487852935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E 2ND ST",
            "address_2": "THIRD FLOOR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071537",
            "telephone_number": "814-877-8013",
            "fax_number": "814-877-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E 2ND ST",
            "address_2": "THIRD FLOOR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071537",
            "telephone_number": "814-877-8013",
            "fax_number": "814-877-8007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAILLIARD",
        "first_name": "ROBERT",
        "middle_name": "L",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-06",
        "last_updated": "2015-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS016253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019567000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Lewis Maholic, DO
• Donna Mahoney, PT, CHT
• Tricia Mahoney, PT
• W Kevin Mahoney, DMD
• Kathy Marie Mahood, M.A.
• Kelly Maine, DPT
• Lisa Anne Mainier, PHD, D.O.
• Henry F Malarkey IV, MD
• Michael Maldonado, CRNA
• Arjun Suresh Malhotra, DO

• Psychologist in Erie, PA
• Providers in Erie, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.