Individual provider Active NPI

Robert L Hodes, PHD

  • Psychologist
  • Madison, WI
National Provider Identifier
1790796415
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1007-057 Issued in WI
Practice address
440 Science Dr Ste 200
Madison, WI 53711-1064
Phone
(608) 238-5176
Fax
(608) 238-2727
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1007-057WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Capitol Associates, SC Psychologist Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1007-057 WI Primary

Addresses

NPPES NPI Registry

Primary practice location

440 Science Dr Ste 200
Madison, WI 53711-1064

Mailing address

440 Science Dr Ste 200
Madison, WI 53711-1064
Phone (608) 238-5176

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
39031700MedicaidWI

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790796415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 SCIENCE DR STE 200",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537111064",
            "telephone_number": "608-238-5176",
            "fax_number": "608-238-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 SCIENCE DR STE 200",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537111064",
            "telephone_number": "608-238-5176",
            "fax_number": "608-238-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODES",
        "first_name": "ROBERT",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1007-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39031700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.