Active NPI
Alexis Nusbaum, PHD
- Clinical Psychologist
- Baltimore, MD
National Provider Identifier
1821050873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2606
- Practice address
- 10 N Greene St
6C-128
Baltimore, MD 21201-1524 - Phone
- (410) 605-7000
- Fax
- (410) 605-7931
- NPI assigned
- Apr 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2606 | MD | Primary |
Addresses
Primary practice location
10 N Greene St
6C-128
Baltimore, MD 21201-1524
Mailing address
585 Main St Ste 143
Laurel, MD 20707-4354
Phone (301) 490-0778
Other names 1
- Dr. Alexis Rosenoer
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250604001053 | MD | Practitioner - Clinical Psychologist | 0042508996 | Practice locations: Columbia, MD |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
9841 Broken Land Pkwy
Suite 116
Columbia, MD 21046-3060
Phone (410) 245-1096
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2606 | MD | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joseph a. Maravi, LLC | 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.
-
- Clinical Social Worker
- Laurel, MD
- NPI 1497232433
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184198400000",
"number": "1821050873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "585 MAIN ST STE 143",
"city": "LAUREL",
"state": "MD",
"postal_code": "207074354",
"telephone_number": "301-490-0778",
"fax_number": "301-498-4663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 N GREENE ST",
"address_2": "6C-128",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212011524",
"telephone_number": "410-605-7000",
"fax_number": "410-605-7931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUSBAUM",
"first_name": "ALEXIS",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-05",
"last_updated": "2007-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "2606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ALEXIS",
"last_name": "ROSENOER",
"prefix": "DR.",
"credential": "PH.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.