Individual provider Active NPI

Yaphet Bryant

  • Clinical Child & Adolescent Psychologist
  • Washington, DC
National Provider Identifier
1760650568
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PSY1000600 Issued in DC
Practice address
111 Michigan Ave NW
Suite 4207 Adolescent Office Main BLDG.
Washington, DC 20010
Phone
(202) 476-4222
Fax
(202) 476-4760
NPI assigned
Feb 14, 2008
Last updated
Oct 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X PSY1000600 DC Primary

Addresses

Primary practice location

111 Michigan Ave NW
Suite 4207 Adolescent Office Main BLDG.
Washington, DC 20010

Mailing address

111 Michigan Ave NW
Suite 4207 Adolescent Office Main BLDG.
Washington, DC 20010
Phone (202) 476-4222

Other practice location 1

1350 Connecticut Ave NW
Washington, DC 20036-1722
Phone (415) 658-6791

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
I20100428000652 DC Practitioner - Clinical Psychologist 2668509399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
One Medstar Primary Care LLCGroup PAC ID 0749607307, 140 clinicians

Practice addresses (Care Compare)

1001 G St NW
Suite 200E
Washington, DC 20001-4546
Phone (202) 660-0005

601 New Jersey Ave NW
Suite 200
Washington, DC 20001-3030
Phone (202) 660-0005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY1000600DCMDClinical Child & Adolescent Psychologist

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

NPI Registry JSON

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1760650568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW",
            "address_2": "SUITE 4207 ADOLESCENT OFFICE MAIN BLDG.",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20010",
            "telephone_number": "202-476-4222",
            "fax_number": "202-476-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW",
            "address_2": "SUITE 4207 ADOLESCENT OFFICE MAIN BLDG.",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20010",
            "telephone_number": "202-476-4222",
            "fax_number": "202-476-4760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 Connecticut Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200361722",
            "country_code": "US",
            "telephone_number": "415-658-6791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "YAPHET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-14",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "DC",
            "license": "PSY1000600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.