Individual provider Active NPI

Donald Cassidy, PHD

  • Clinical Psychologist
  • Bethesda, MD
National Provider Identifier
1770511347
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
02693 Issued in MD
Practice address
6040 Southport Dr
Bethesda, MD 20814-1848
Phone
(301) 493-4200
Fax
(301) 493-6209
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 02693 MD Primary

Addresses

Primary practice location

6040 Southport Dr
Bethesda, MD 20814-1848

Mailing address

19900 New Hampshire Ave
Brinklow, MD 20862-9744
Phone (301) 493-4200

Other identifiers 1

IdentifierTypeStateIssuer
52473002OtherMDCAREFIRST NON PAR #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20191226001252 NJ Practitioner - Clinical Psychologist 4486088507 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Care Therapy LLCGroup PAC ID 0547335366, 140 clinicians

Practice addresses (Care Compare)

85 Crescent Ave
Passaic, NJ 07055-2437
Phone (973) 264-0023

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02693MDMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Care Therapy LLC Clinical CurrentSince Feb 1, 2022 Accepting new patients
Jewish Family Service of Atlantic County CurrentSince Aug 4, 2019 Accepting new patients
NJ Behavioral Health Services PC Clinical CurrentSince Jul 25, 2020 Accepting new patients

Locations

2719 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 354-2555

607 N Jerome Ave
Margate City, NJ 08402
Phone (609) 822-1108

140 E Ridgewood Ave
Ste 415
Paramus, NJ 07652
Phone (201) 720-1900

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1770511347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19900 NEW HAMPSHIRE AVE",
            "city": "BRINKLOW",
            "state": "MD",
            "postal_code": "208629744",
            "telephone_number": "301-493-4200",
            "fax_number": "301-493-6209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 SOUTHPORT DR",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208141848",
            "telephone_number": "301-493-4200",
            "fax_number": "301-493-6209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "DONALD",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "02693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST NON PAR #",
            "identifier": "52473002",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.