Active NPI
Robert W. Anderson, PH. D
- Psychologist
- Wellsville, NY
National Provider Identifier
1669578126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 007903-1
- Practice address
- 45 N Broad St
Wellsville, NY 14895-1224 - Phone
- (585) 593-3991
- Fax
- (585) 593-7104
- NPI assigned
- Sep 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 007903-1 | NY | Primary |
Addresses
Primary practice location
45 N Broad St
Wellsville, NY 14895-1224
Mailing address
PO Box 62
Wellsville, NY 14895-0062
Phone (585) 593-1991
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090526000266 | NY | Practitioner - Clinical Psychologist | 8729067095 | Practice locations: Hornell, NY; Wellsville, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
97 Main St a
Hornell, NY 14843-1523
Phone (585) 593-1991
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007903-1 | NY | MD | Psychologist |
| 007903 | NY | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allegany County Community Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Case Management Agency
- Wellsville, NY
- NPI 1316111636
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206489600000",
"number": "1669578126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 62",
"city": "WELLSVILLE",
"state": "NY",
"postal_code": "148950062",
"telephone_number": "585-593-1991",
"fax_number": "585-593-7104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 N BROAD ST",
"city": "WELLSVILLE",
"state": "NY",
"postal_code": "148951224",
"telephone_number": "585-593-3991",
"fax_number": "585-593-7104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "ROBERT",
"middle_name": "W.",
"name_prefix": "Dr.",
"credential": "PH. D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-15",
"last_updated": "2008-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "007903-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wellsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.