Richard T Elmore Jr., PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY3228 Issued in FL

Practice address

100 Rialto PL
Suite 754
Melbourne, FL 32901-3055

Phone

(321) 728-9620

Fax

(321) 951-1928

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Clinical Psychologist

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Richard T Elmore Jr PHD PA

  • Psychologist
  • Melbourne, FL
  • NPI 1700116274
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262736000000",
    "number": "1740214766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RIALTO PL",
            "address_2": "SUITE 754",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013055",
            "telephone_number": "321-728-9620",
            "fax_number": "321-951-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RIALTO PL",
            "address_2": "SUITE 754",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013055",
            "telephone_number": "321-728-9620",
            "fax_number": "321-951-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMORE",
        "first_name": "RICHARD",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2010-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY3228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "75204",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PROVIDER #",
            "identifier": "592345361",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Petra Gabriele Elliott, MS
• Tiffany M Ellis, M.D.
• Andrea Lee Ellison, ARNP
• Samanta Elmer
• Amber Elmore, APRN
• Michael Kyle Ely
• Louis John Emen, PTA
• Emeritus Properties NGH, LLC
• Amanda M Emerson, DNP
• Olga Dorjima Emgushov, MD,MPH

• Psychologist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; 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.

Verify at the official NPI Registry.