John Andrew Peltz, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6175 Issued in OH

Practice address

8118 Corporate Way Ste 121
Mason, OH 45040

Phone

(513) 919-5860

NPI assigned

May 21, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1609085570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11985 HARBORTOWN DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452491757",
            "telephone_number": "513-919-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8118 CORPORATE WAY STE 121",
            "city": "MASON",
            "state": "OH",
            "postal_code": "45040",
            "telephone_number": "513-919-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELTZ",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "6175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Mason, OH
• Providers in Mason, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.