Individual provider Active NPI

Allen Zaklad, PHD

  • Clinical Psychologist
  • Philadelphia, PA
National Provider Identifier
1881719656
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS002928L Issued in PA
Practice address
121 N Broad St
Philadelphia, PA 19107-1913
Phone
(215) 569-8414
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
No

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 PS002928L PA Primary

Addresses

Primary practice location

121 N Broad St
Philadelphia, PA 19107-1913

Mailing address

519 Glen Echo Rd
Philadelphia, PA 19119-2917

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
I20141202001625 PA Practitioner - Clinical Psychologist 9133290075 Reassigns benefits to 1 organization
Practice locations: Philadelphia, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

519 Glen Echo Rd
Philadelphia, PA 19119-2917

6703 Germantown Ave
Suite 200
Philadelphia, PA 19119-2109
Phone (215) 848-4380

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS002928LPAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Comhar Inc CurrentSince Jul 2, 2009 Accepting new patients
Comhar, Inc Current Accepting new patients

Locations

2055 E Allegheny Ave
Philadelphia, PA 19134
Phone (215) 427-5800

100 W Lehigh Ave
Philadelphia, PA 19133
Phone (215) 203-3000

Organizations & group practices 2

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881719656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 GLEN ECHO RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191192917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071913",
            "telephone_number": "215-569-8414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAKLAD",
        "first_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS002928L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.