Individual provider Active NPI

Susan Marie Mastruserio, PSYD

  • Counseling Psychologist
  • Greensburg, PA
National Provider Identifier
1790243533
Registry record updated Jan 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PS018749 Issued in PA
Practice address
440 Pellis Rd Unit a
Greensburg, PA 15601-4529
Phone
(412) 996-3306
NPI assigned
Mar 12, 2019
Last updated
Jan 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PS018749 PA Primary

Addresses

Primary practice location

440 Pellis Rd Unit a
Greensburg, PA 15601-4529

Mailing address

440 Pellis Rd Unit a
Greensburg, PA 15601-4529
Phone (412) 996-3306

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
I20241029001681 PA Practitioner - Clinical Psychologist 5496288532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

510 Pellis Rd
Suite 203
Greensburg, PA 15601-4583
Phone (724) 216-3358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS018749PAMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Good Thoughts Therapeutic Services, PLLC CurrentSince Aug 16, 2023 Accepting new patients
Elevation Psychological Services Counseling CurrentSince Jun 27, 2021 Accepting new patients

Locations

440 Pellis Rd
Unit A
Greensburg, PA 15601
Phone (412) 996-3306

510 Pellis Rd
Ste 203
Greensburg, PA 15601
Phone (724) 216-3358

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, 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": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611360000000",
    "number": "1790243533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 PELLIS RD UNIT A",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156014529",
            "telephone_number": "412-996-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 PELLIS RD UNIT A",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156014529",
            "telephone_number": "412-996-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTRUSERIO",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-12",
        "last_updated": "2021-01-23",
        "certification_date": "2021-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PA",
            "license": "PS018749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensburg, PA

Sources for this page

Verify at the official NPI Registry.