Individual provider Active NPI

Kami McManus, MS, MFT, PSYD

  • Clinical Psychologist
  • Philadelphia, PA
National Provider Identifier
1609565480
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS019881 Issued in PA
Practice address
3624 Market St Ste 201
Philadelphia, PA 19104-2614
Phone
(800) 789-7366
Fax
(215) 615-3671
NPI assigned
May 5, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Health Psychologist 103TH0004X
Health Service Psychologist 103TH0100X
Sleep Specialist (PhD) 173F00000X PS019881 PA
Clinical Psychologist 103TC0700X PS019881 PA Primary

Addresses

Primary practice location

3624 Market St Ste 201
Philadelphia, PA 19104-2614

Mailing address

3624 Market St Ste 201
Philadelphia, PA 19104-2614
Phone (215) 662-7772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240222001591 PA Practitioner - Psychiatry 2860836442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3624 Market St
FL 2
Philadelphia, PA 19104-5803
Phone (215) 662-7772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Master of Science

State licenses

LicenseStateTypeSpecialty
PS019881PAMDSleep Specialist (PhD)

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group CurrentSince Jan 10, 2024 Accepting new patients
University of Penn-Medical Group CurrentSince Jan 10, 2024 Accepting new patients

Locations

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1683244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1609565480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 MARKET ST STE 201",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042614",
            "telephone_number": "215-662-7772",
            "fax_number": "215-615-3671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3624 MARKET ST STE 201",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042614",
            "telephone_number": "800-789-7366",
            "fax_number": "215-615-3671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMANUS",
        "first_name": "KAMI",
        "name_prefix": "Dr.",
        "credential": "MS, MFT, PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-05",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "173F00000X",
            "taxonomy_group": "",
            "desc": "Sleep Specialist, PhD",
            "state": "PA",
            "license": "PS019881",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS019881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.