Gina Marie Dattilo, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS017764 Issued in PA

Practice address

293 Hopewell Rd
Elverson, PA 19520

Phone

(540) 209-4717

NPI assigned

Aug 27, 2008

Last updated

Aug 28, 2018By the provider in NPPES

Sex

Female

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

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Optum Behavioral Care of Connecticut PCGroup PAC ID 9436502879, 132 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gina.marie.dattilo.1@28623.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Optum Behavioral Care of Connecticut, P.C.

  dba Springfield Behavioral of Pennsylvania

  • Counseling Psychologist
  • Philadelphia, PA
  • NPI 1811778988
  Medicare reassignment Care Compare group NPD
• Springfield Psychological PC

  dba Associates of Springfield Psychological

  • Mental Health Counselor
  • Springfield, PA
  • NPI 1295705317
  NPD
• Optum Behavioral Care of Connecticut, P.C.

  • Clinical Social Worker
  • Providence, RI
  • NPI 1730972944
  NPD

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1497902829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "293 HOPEWELL RD",
            "city": "ELVERSON",
            "state": "PA",
            "postal_code": "195208804",
            "telephone_number": "540-209-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 HOPEWELL RD",
            "city": "ELVERSON",
            "state": "PA",
            "postal_code": "19520",
            "telephone_number": "540-209-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATTILO",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS017764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMONWELATH OF PENNSYLVANIA DEPARTMENT OF STATE BUREAU OF PROFESSIONAL AND OCCU",
            "identifier": "PS017764",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gordon Richard Eck, D.O.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; 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.