Individual provider Active NPI

Victor Masone Jr., PH.D.

  • Psychologist
  • Edinboro, PA
National Provider Identifier
1881780435
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS-003450-L Issued in PA
Practice address
7052 Route 6N
Edinboro, PA 16412-9610
Phone
(814) 734-3975
Fax
(814) 734-1265
NPI assigned
Oct 4, 2006
Last updated
Jan 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS-003450-L PA Primary

Addresses

Primary practice location

7052 Route 6N
Edinboro, PA 16412-9610

Mailing address

7052 Route 6N
Edinboro, PA 16412-9610
Phone (814) 734-3975

Other identifiers 2

IdentifierTypeStateIssuer
429832OtherPAHIGHMARK
0011606710001MedicaidPA

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
I20120328000172 PA Practitioner - Clinical Psychologist 9436319548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Edinboro Counseling and Psychological ServicesGroup PAC ID 2769758085, 2 clinicians

Practice addresses (Care Compare)

7052 Route 6N
Edinboro, PA 16412-9610
Phone (814) 734-3975

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS-003450-LPAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Edinboro Counseling and Psychological Services Psychologist CurrentSince Feb 2, 2020 Accepting new patients

Locations

108 High St
Edinboro, PA 16412
Phone (814) 734-3975

7052 Route 6N
Edinboro, PA 16412
Phone (814) 734-3975

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, 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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1881780435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7052 ROUTE 6N",
            "city": "EDINBORO",
            "state": "PA",
            "postal_code": "164129610",
            "telephone_number": "814-734-3975",
            "fax_number": "814-734-1265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7052 ROUTE 6N",
            "city": "EDINBORO",
            "state": "PA",
            "postal_code": "164129610",
            "telephone_number": "814-734-3975",
            "fax_number": "814-734-1265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASONE",
        "first_name": "VICTOR",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS-003450-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "429832",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011606710001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinboro, PA

Sources for this page

Verify at the official NPI Registry.