Active NPI
Douglas Michael Buyer, PHD, LLC
- Clinical Child & Adolescent Psychologist
- Erie, PA
National Provider Identifier
1891790358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- PS006323L
- Practice address
- 1438 W 38TH St
Erie, PA 16508-2324 - Phone
- (814) 315-4054
- Fax
- (814) 281-3061
- NPI assigned
- Jun 20, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | PS006323L | PA | Primary |
| Health Service Psychologist | 103TH0100X | PS-006323-L | PA |
Addresses
Primary practice location
1438 W 38TH St
Erie, PA 16508-2324
Mailing address
1438 W 38TH St
Erie, PA 16508-2324
Phone (814) 315-4054
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01486280 | Medicaid | PA | |
| 1891790358 | Other | PA | MEDICARE-NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS-006323-L | PA | MD | Health Service Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Beacon Group LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Erie, PA
- NPI 1689695868
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543276800000",
"number": "1891790358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1438 W 38TH ST",
"city": "ERIE",
"state": "PA",
"postal_code": "165082324",
"telephone_number": "814-315-4054",
"fax_number": "814-455-5656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1438 W 38TH ST",
"city": "ERIE",
"state": "PA",
"postal_code": "165082324",
"telephone_number": "814-315-4054",
"fax_number": "814-281-3061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUYER",
"first_name": "DOUGLAS",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "PHD, LLC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-20",
"last_updated": "2018-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "PA",
"license": "PS006323L",
"primary": true
},
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "PA",
"license": "PS-006323-L",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01486280",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE-NPI",
"identifier": "1891790358",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.