Active NPI
James Thomas Wegner, PHD
- Psychologist
- Westport, CT
National Provider Identifier
1861507428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1174
- Practice address
- 57 Old Road
Westport, CT 06880 - Phone
- (203) 254-2842
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1174 | CT | Primary |
Addresses
Primary practice location
57 Old Road
Westport, CT 06880
Mailing address
57 Old Road
Westport, CT 06880
Phone (203) 254-2842
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111118000027 | CT | Practitioner - Clinical Psychologist | 0244404713 | Practice locations: Pacific Palisades, CA |
| I20231025003527 | CA | Practitioner - Clinical Psychologist | 0244404713 | Practice locations: Pacific Palisades, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1144 Iliff St
Pacific Palisades, CA 90272-3829
Phone (203) 635-3044
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28575 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861507428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 OLD ROAD",
"city": "WESTPORT",
"state": "CT",
"postal_code": "06880",
"telephone_number": "203-254-2842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57 OLD ROAD",
"city": "WESTPORT",
"state": "CT",
"postal_code": "06880",
"telephone_number": "203-254-2842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEGNER",
"first_name": "JAMES",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CT",
"license": "1174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westport, CT
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.
- 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.