Individual provider Active NPI

Joseph G Schaller, PSY.D.

  • Clinical Psychologist
  • Wayne, PA
National Provider Identifier
1780606178
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS009283L Issued in PA
Practice address
303 W Lancaster Ave
Suite 2C
Wayne, PA 19087-3938
Phone
(610) 995-0189
Fax
(610) 995-0194
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 PS009283L PA Primary

Addresses

Primary practice location

303 W Lancaster Ave
Suite 2C
Wayne, PA 19087-3938

Mailing address

303 W Lancaster Ave
Suite 2C
Wayne, PA 19087-3938
Phone (610) 995-0189

Other identifiers 3

IdentifierTypeStateIssuer
336520OtherPAMAGELLAN
1400145OtherPAHIGHMARK BLUE SHIELD
1400145OtherPAINDEPENDENCE 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
I20060404000221 PA Practitioner - Clinical Psychologist 4688681315 Practice locations: Philadelphia, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

604 E Cathedral Rd
Philadelphia, PA 19128-1957
Phone (610) 716-8635

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS009283LPAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780606178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 W LANCASTER AVE",
            "address_2": "SUITE 2C",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190873938",
            "telephone_number": "610-995-0189",
            "fax_number": "610-995-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W LANCASTER AVE",
            "address_2": "SUITE 2C",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190873938",
            "telephone_number": "610-995-0189",
            "fax_number": "610-995-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHALLER",
        "first_name": "JOSEPH",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS009283L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "336520",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1400145",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "1400145",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, PA

Sources for this page

Verify at the official NPI Registry.