Individual provider Active NPI

Phillip Tenaglia, MA

  • Psychologist
  • Southampton, PA
National Provider Identifier
1811926090
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS008045L Issued in PA
Practice address
928 Jaymor Rd Ste B-150
Southampton, PA 18966-3853
Phone
(215) 947-8654
Fax
(215) 938-7607
NPI assigned
Jul 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS008045L PA Primary

Addresses

Primary practice location

928 Jaymor Rd Ste B-150
Southampton, PA 18966-3853

Mailing address

2910 Franks Rd
Suite 1
Huntingdon Valley, PA 19006-4215
Phone (215) 947-8654

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
PS008045LPAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Growth Opportunity Center Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1811926090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 FRANKS RD",
            "address_2": "SUITE 1",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190064215",
            "telephone_number": "215-947-8654",
            "fax_number": "215-938-7607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 JAYMOR RD STE B-150",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189663853",
            "telephone_number": "215-947-8654",
            "fax_number": "215-938-7607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENAGLIA",
        "first_name": "PHILLIP",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS008045L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.