Individual provider Active NPI

Jonathan A. Moselle, PH.D.

  • Clinical Psychologist
  • Fort Washington, PA
National Provider Identifier
1841350683
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS003458-L Issued in PA
Practice address
1244 Fort Washington Ave
Suite K
Ft Washington, PA 19034-1743
Phone
(215) 643-2999
NPI assigned
Dec 11, 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 PS003458-L PA Primary

Addresses

Primary practice location

1244 Fort Washington Ave
Suite K
Ft Washington, PA 19034-1743

Mailing address

1244 Fort Washington Ave
Suite K
Ft Washington, PA 19034-1743
Phone (215) 643-2999

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
I20120419000348 PA Practitioner - Clinical Psychologist 4688835598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1244 Ft Washington Ave
Suite K
Ft Washington, PA 19034-1743
Phone (215) 643-2999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS003458-LPAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan a. Moselle,PH.D. P.C Clinical CurrentSince Oct 30, 2011 Accepting new patients

Locations

1244 Fort Washington Ave
Ste K
Ft Washington, PA 19034
Phone (215) 643-2999

255 S 17th St
Ste 2601
Philadelphia, PA 19103
Phone (215) 635-5202

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, 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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841350683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1244 FORT WASHINGTON AVE",
            "address_2": "SUITE K",
            "city": "FT WASHINGTON",
            "state": "PA",
            "postal_code": "190341743",
            "telephone_number": "215-643-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 FORT WASHINGTON AVE",
            "address_2": "SUITE K",
            "city": "FT WASHINGTON",
            "state": "PA",
            "postal_code": "190341743",
            "telephone_number": "215-643-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSELLE",
        "first_name": "JONATHAN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS003458-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Washington, PA

Sources for this page

Verify at the official NPI Registry.