Michael J Phillips, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00001614 Issued in WA

Practice address

55 1St PL NW
Issaquah, WA 98027-3271

Phone

(425) 392-0277

Fax

(425) 392-2509

NPI assigned

Jan 8, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in WA

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

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497803001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 1ST PL NW",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980273271",
            "telephone_number": "425-392-0277",
            "fax_number": "425-392-2509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 1ST PL NW",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980273271",
            "telephone_number": "425-392-0277",
            "fax_number": "425-392-2509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00001614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE PIN",
            "identifier": "4655971",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE PIN",
            "identifier": "PH3914",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Peter
• Dmitry Peysakhov, D.M.D.
• Lele Pham, RPH
• Phenix Physical Therapy & Personal Wellness, LLC
• Brittany C Philio, PA-C
• Vivien Johnette Phillips, PSY.D.
• Charlie L Phu, PA-C
• Physiotherapy Associate Inc
• Allison Frances Pick, DPT
• Menze Pickering

• Clinical Psychologist in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.