Individual provider Active NPI

Stephen Edward Liptak, PSY.D

  • Psychologist
  • Troy, OH
National Provider Identifier
1639194434
Registry record updated Feb 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4619 Issued in OH
Practice address
3130 N County Road 25a
Troy, OH 45373-1337
Phone
(937) 440-7626
Fax
(937) 440-7702
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4619 OH Primary

Addresses

Primary practice location

3130 N County Road 25a
Troy, OH 45373-1337

Mailing address

3130 N County Road 25a
Troy, OH 45373-1337
Phone (937) 440-7626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20080218000237 OH Practitioner - Clinical Psychologist 2163505942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Uvpc Specialists, Inc.Group PAC ID 8921022260, 80 clinicians

Practice addresses (Care Compare)

3130 N Count Rd
Troy, OH 45373-1337

Merit-based Incentive Payment System (MIPS)

Final score
87.12 of 100Reported as group
Quality
84.25
Promoting interoperability
100
Improvement activities
40
Cost
72.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4619OHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Uvpc Specialists Inc. CurrentSince Apr 1, 2014 Accepting new patients
Uvpc Specialists, Inc. CurrentSince Apr 1, 2014 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

3170 Kettering Blvd
Fl 3
Moraine, OH 45439

3130 N County Road 25A
Ste 212
Troy, OH 45373
Phone (937) 335-0061

3130 N County Road 25A
Troy, OH 45373
Phone (937) 440-4000

Organizations & group practices 3

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391558400000",
    "number": "1639194434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 N COUNTY ROAD 25A",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453731337",
            "telephone_number": "937-440-7626",
            "fax_number": "937-440-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 N COUNTY ROAD 25A",
            "city": "TROY",
            "state": "OH",
            "postal_code": "453731337",
            "telephone_number": "937-440-7626",
            "fax_number": "937-440-7702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPTAK",
        "first_name": "STEPHEN",
        "middle_name": "EDWARD",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2014-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "4619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, OH

Sources for this page

Verify at the official NPI Registry.