Individual provider Active NPI

Thomas Paul Delaney, PHD

  • Clinical Psychologist
  • San Dimas, CA
National Provider Identifier
1699794388
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY16600 Issued in CA
Practice address
1173 N Dixie Dr
Ste. 101
San Dimas, CA 91773-1200
Phone
(626) 231-7500
Fax
(909) 447-0522
NPI assigned
Jul 19, 2006
Last updated
Feb 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY16600 CA Primary

Addresses

Primary practice location

1173 N Dixie Dr
Ste. 101
San Dimas, CA 91773-1200

Mailing address

1173 N Dixie Dr
Ste. 101
San Dimas, CA 91773-1200
Phone (626) 231-7500

Other identifiers 3

IdentifierTypeStateIssuer
PSY166000OtherCAMEDI-CAL
CP16600AOtherCAMEDICARE PTAN S.CA
CA230030OtherCAMEDICARE PTAN N.CA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20041022000805 CA Practitioner - Clinical Psychologist 4981665981 Practice locations: Riverside, CA; San Dimas, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1173 N Dixie Dr
Suite 101
San Dimas, CA 91773-1200
Phone (626) 231-7500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY16600CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Joshua Kritsada Koh a Professional Psychiatric Corporation PastSince Jan 18, 2011 Accepting new patients
Lina Shuhaibar MD, Inc. a Professional Corporation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: casacolina@direct.casacolina.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1699794388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1173 N DIXIE DR",
            "address_2": "STE. 101",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731200",
            "telephone_number": "626-231-7500",
            "fax_number": "909-447-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1173 N DIXIE DR",
            "address_2": "STE. 101",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731200",
            "telephone_number": "626-231-7500",
            "fax_number": "909-447-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELANEY",
        "first_name": "THOMAS",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "PSY166000",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN S.CA",
            "identifier": "CP16600A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN N.CA",
            "identifier": "CA230030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

Verify at the official NPI Registry.