Individual provider Active NPI

Lanning Moldauer, PH.D.

  • Psychologist
  • Washington, DC
National Provider Identifier
1720101926
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1348 Issued in DC
Practice address
5619 33Rd St NW
Washington, DC 20015-1630
Phone
(202) 244-5293
Fax
(202) 318-2328
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1348 DC Primary
Psychologist 103T00000X 1700 MD

Addresses

Primary practice location

5619 33Rd St NW
Washington, DC 20015-1630

Mailing address

5619 33Rd St NW
Washington, DC 20015-1630
Phone (202) 244-5293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20120910000475 DC Practitioner - Clinical Psychologist 7113175530 Practice locations: Washington, DC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5619 33Rd St NW
Washington, DC 20015-1630

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1348DCMDPsychologist
1700MDMDPsychologist
01700MDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lanning Moldauer PH.D., LLC Psychologist 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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720101926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5619 33RD ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200151630",
            "telephone_number": "202-244-5293",
            "fax_number": "202-318-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5619 33RD ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200151630",
            "telephone_number": "202-244-5293",
            "fax_number": "202-318-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLDAUER",
        "first_name": "LANNING",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "DC",
            "license": "1348",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "1700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.