Shervin Tehrani-Rad, PSYD, MPH

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301017839 Issued in MI

Practice address

415 Main St Ste a
Saint Joseph, MI 49085-3100

Phone

(269) 408-1688

NPI assigned

Aug 27, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychiatric Specialties, PLCGroup PAC ID 5799729265, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/27120/brand/1/csg/1/fhir/r4

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.

• Psychiatric Specialties, PLC

  • Psychiatry Physician
  • Saint Joseph, MI
  • NPI 1841321072

  Clinical

  Medicare reassignment Care Compare group NPD
• Psychiatric and Psychological Specialties

  • Clinical Psychologist
  • Saint Joseph, MI
  • NPI 1548672728
  NPD

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665273600000",
    "number": "1619225489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MAIN ST STE A",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853100",
            "telephone_number": "269-408-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MAIN ST STE A",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853100",
            "telephone_number": "269-408-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEHRANI-RAD",
        "first_name": "SHERVIN",
        "name_prefix": "Dr.",
        "credential": "PSYD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-27",
        "last_updated": "2022-10-09",
        "certification_date": "2022-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "33059",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "6301017839",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301017839",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "33059",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "33059",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301017839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Dawn Talonen, COTA
• Paul Kaling Tam, MD
• Hiu Tung Tang
• Carlos Alberto Tavarez
• Brian Timothy Taylor
• Debora Tenter, NP
• David W Terhune, M.D.
• Teter Orthotics & Prosthetics, Inc
• The Benton Harbor-St. Joseph Young Men'S Christian Association
• The Pharmacy Shoppe, Inc.

• Clinical Psychologist in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2022; 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.