David Ian Rudick, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS004382L Issued in PA

Practice address

93 Old York Rd
Suite 203
Jenkintown, PA 19046-3925

Phone

(215) 885-3337

NPI assigned

Nov 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sri Psychological Services PCGroup PAC ID 1456331214, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Sri Psychological Services, PC

  • Psychologist
  • Jenkintown, PA
  • NPI 1730259904
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770653222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 OLD YORK RD",
            "address_2": "SUITE 203",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190463925",
            "telephone_number": "215-885-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 OLD YORK RD",
            "address_2": "SUITE 203",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190463925",
            "telephone_number": "215-885-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDICK",
        "first_name": "DAVID",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS004382L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Stella Romero
• Derek Rose, MS
• Diana Shirley Rosenstein, PH.D.
• Nancy R Rosenthal, DDS
• Michael D Roth, DDS
• Dorothea L. Rudolf
• Ellen Russakoff, LCSW
• Jessie Kirkcaldy Russell-Nisbet, L.S.W.
• Anna Grace Russell, NCC
• John J Russell

• Psychologist in Jenkintown, PA
• Providers in Jenkintown, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.