Individual provider Active NPI

James H Rough, PSYD

  • Psychologist
  • Portland, ME
National Provider Identifier
1679694129
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS1087 Issued in ME
Practice address
225 Commercial St
Suite 401
Portland, ME 04101-4613
Phone
(207) 771-2001
Fax
(207) 771-2001
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS1087 ME Primary

Addresses

Primary practice location

225 Commercial St
Suite 401
Portland, ME 04101-4613

Mailing address

225 Commercial St
Suite 401
Portland, ME 04101-4613
Phone (207) 771-2001

Other identifiers 3

IdentifierTypeStateIssuer
115243OtherMEMARTINS POINT
7096738OtherMEAETNA
047373OtherMEANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20090205000108 ME Practitioner - Clinical Psychologist 3678637675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

44 Exchange St
Suite 200
Portland, ME 04101-5018
Phone (207) 771-2001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Collaborative Psychotherapy PA Psychologist CurrentSince Nov 23, 2009 Accepting new patients

Locations

44 Exchange St
Ste 200
Portland, ME 04101
Phone (207) 200-4150

225 Commercial St
Ste 401
Portland, ME 04101
Phone (207) 771-2001

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1679694129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 COMMERCIAL ST",
            "address_2": "SUITE 401",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041014613",
            "telephone_number": "207-771-2001",
            "fax_number": "207-771-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 COMMERCIAL ST",
            "address_2": "SUITE 401",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041014613",
            "telephone_number": "207-771-2001",
            "fax_number": "207-771-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUGH",
        "first_name": "JAMES",
        "middle_name": "H",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ME",
            "license": "PS1087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARTINS POINT",
            "identifier": "115243",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7096738",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "047373",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.