David Jason Schroerlucke, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

267542 Issued in KY

Practice address

633 Baxter Ave
Louisville, KY 40204-1157

Phone

(502) 309-2408

NPI assigned

Aug 30, 2010

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

Medicare fee-for-service enrollment

Enrolled in KY

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Mandala House, LLC

  • Clinical Psychologist
  • Louisville, KY
  • NPI 1659829760
  Medicare reassignment NPD
• Ripe Minds, LLC

  • Clinical Psychologist
  • Shepherdsville, KY
  • NPI 1699546580
  Medicare reassignment NPD

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606003200000",
    "number": "1598071474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 BAXTER AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041157",
            "telephone_number": "502-309-2408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 BAXTER AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041157",
            "telephone_number": "502-309-2408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROERLUCKE",
        "first_name": "DAVID",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-30",
        "last_updated": "2020-11-22",
        "certification_date": "2020-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "267542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Sue Schroeder, RD, CSSD
• Susan Schroeder
• Zephan Schroeder
• Derek Adam Schroering, D.C.
• Robert L Schroering, DMD
• Susan Kim Schroerlucke, NURSE PRACTITIONER
• Andrea K Schroeter, DPT
• Tiarra Schueler, RBT
• Frederick J. Schuette, DMD
• Charles F. Schuetter, D.M.D.

• Clinical Psychologist in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2020; 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.