Individual provider Active NPI

Elayne P Baumgart, PH D

  • Clinical Psychologist
  • Beachwood, OH
National Provider Identifier
1871716449
Registry record updated Sep 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3229 Issued in OH
Practice address
3937 W Meadow LN
Beachwood, OH 44122-4720
Phone
(216) 591-1664
NPI assigned
Apr 11, 2007
Last updated
Sep 29, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2008

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 3229 OH Primary

Addresses

Primary practice location

3937 W Meadow LN
Beachwood, OH 44122-4720

Mailing address

PO Box 35216
Canton, OH 44735-5216
Phone (216) 591-1664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20070508000445 OH Practitioner - Clinical Psychologist 4183720154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Partners for Behavioral Health and Wellness IncGroup PAC ID 6305088972, 22 clinicians

Practice addresses (Care Compare)

24800 Highpoint Rd a
Beachwood, OH 44122-6051
Phone (216) 342-5496

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3229OHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Partners for Behavioral Health and Wellness Inc CurrentSince Aug 15, 2016 Accepting new patients

Locations

24800 Highpoint Rd
Beachwood, OH 44122
Phone (216) 342-5496

24800 Highpoint Rd
Ste A
Beachwood, OH 44122
Phone (216) 342-5496

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": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222646400000",
    "number": "1871716449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35216",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447355216",
            "telephone_number": "216-591-1664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3937 W MEADOW LN",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224720",
            "telephone_number": "216-591-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMGART",
        "first_name": "ELAYNE",
        "middle_name": "P",
        "credential": "PH D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2008-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "3229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.