Individual provider Active NPI

Thaddeus Michael Midas, PH.D.

  • Group Psychotherapy Psychologist
  • Lehighton, PA
National Provider Identifier
1740249630
Registry record updated Dec 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
License
PS003455-L Issued in PA
Practice address
701 Bridge St
Suite 206
Lehighton, PA 18235-1800
Phone
(610) 377-6155
Fax
(610) 377-9765
NPI assigned
Mar 21, 2006
Last updated
Dec 10, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy Psychologist 103TP2701X PS003455-L PA Primary

Addresses

Primary practice location

701 Bridge St
Suite 206
Lehighton, PA 18235-1800

Mailing address

701 Bridge St
Suite 206
Lehighton, PA 18235-1800
Phone (610) 377-6155

Other identifiers 3

IdentifierTypeStateIssuer
4455111OtherPAAETNA
818748OtherPANORTHEAST BLUE CROSS BLUE SHIELD
50008809OtherPACAPITAL BLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20070110000355 PA Practitioner - Clinical Psychologist 1951301209 Practice locations: Lehighton, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

701 Bridge St
Suite 206
Lehighton, PA 18235-1800
Phone (610) 377-6155

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS003455-LPAMDGroup Psychotherapy Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386633600000",
    "number": "1740249630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 BRIDGE ST",
            "address_2": "SUITE 206",
            "city": "LEHIGHTON",
            "state": "PA",
            "postal_code": "182351800",
            "telephone_number": "610-377-6155",
            "fax_number": "610-377-9765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 BRIDGE ST",
            "address_2": "SUITE 206",
            "city": "LEHIGHTON",
            "state": "PA",
            "postal_code": "182351800",
            "telephone_number": "610-377-6155",
            "fax_number": "610-377-9765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDAS",
        "first_name": "THADDEUS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2013-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "PA",
            "license": "PS003455-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4455111",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTHEAST BLUE CROSS BLUE SHIELD",
            "identifier": "818748",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50008809",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehighton, PA

Sources for this page

Verify at the official NPI Registry.