Individual provider Active NPI

Robert W. Anderson, PH. D

  • Psychologist
  • Wellsville, NY
National Provider Identifier
1669578126
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
007903-1 Issued in NY
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

Updated by the provider on Mar 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
007903-1NYMDPsychologist
007903NYMDOptician

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.