Individual provider Active NPI

Jessica A Macdonald, PSY.D.

  • Clinical Neuropsychologist
  • Cincinnati, OH
National Provider Identifier
1780072561
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
7249 Issued in OH
Practice address
4805 Montgomery Rd Ste 210
Cincinnati, OH 45212-2280
Phone
(513) 961-5558
NPI assigned
Jan 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 243398 KY
Clinical Neuropsychologist 103G00000X 7249 OH Primary

Addresses

Primary practice location

4805 Montgomery Rd Ste 210
Cincinnati, OH 45212-2280

Mailing address

4805 Montgomery Rd Ste 150
Cincinnati, OH 45212-2280
Phone (513) 961-5558

Other practice location 1

320 Thomas More Pkwy
Crestview Hills, KY 41017-3410
Phone (859) 341-4266

Other identifiers 2

IdentifierTypeStateIssuer
7100416660MedicaidKY
0179578MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20170523001701 OH Practitioner - Clinical Psychologist 0345517355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverhills Healthcare IncGroup PAC ID 6103719596, 48 clinicians

Practice addresses (Care Compare)

4805 Montgomery Rd
Cincinnati, OH 45212-2198
Phone (513) 241-2370

4805 Montgomery Rd
Cincinnati, OH 45212-2280

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverhills Healthcare, Inc. Clinical Neuropsychologist PastSince Jul 31, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jmacdonald@rhi.gwaydirect.com

Organizations & group practices 2

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": "1420156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1780072561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4805 MONTGOMERY RD STE 150",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122280",
            "telephone_number": "513-961-5558",
            "fax_number": "513-961-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 MONTGOMERY RD STE 210",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122280",
            "telephone_number": "513-961-5558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Thomas More Pkwy",
            "address_purpose": "LOCATION",
            "city": "Crestview Hills",
            "state": "KY",
            "postal_code": "410173410",
            "country_code": "US",
            "telephone_number": "859-341-4266",
            "fax_number": "859-344-5076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "JESSICA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-02",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "KY",
            "license": "243398",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "OH",
            "license": "7249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100416660",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0179578",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.