Mary Pelham, PSY.D

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PS015401 Issued in PA

Practice address

60 Township Line Rd
Moss Rehab
Elkins Park, PA 19027-2220

Phone

(215) 663-6270

Fax

(215) 663-6739

NPI assigned

Feb 5, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Albert Einstein Medical CenterGroup PAC ID 3971412297, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Albert Einstein Medical Center

  • Psychologist
  • Phila, PA
  • NPI 1609832286
  Medicare reassignment Care Compare group NPD
• Albert Einstein Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Phila, PA
  • NPI 1881798320
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902944432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E OLNEY AVE",
            "address_2": "SUITE 505",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191202421",
            "telephone_number": "215-254-2630",
            "fax_number": "215-254-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 TOWNSHIP LINE RD",
            "address_2": "MOSS REHAB",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190272220",
            "telephone_number": "215-663-6270",
            "fax_number": "215-663-6739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELHAM",
        "first_name": "MARY",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "PA",
            "license": "PS015401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan C Pashko, P.T.
• Keshav Ashwin Patel, DMD
• Patient Love Home Care LLC
• Peace Birth and Wellness
• Peace of Mind Social Services
• Jean Marie Pellegrino, CRNP
• Penn Therapeutic Inc
• Penn Therapeutic Inc
• Penrose Family Dentistry PC
• Ivelisse Marie Perez

• Clinical Neuropsychologist in Elkins Park, PA
• Providers in Elkins Park, PA by specialty
• Clinical Neuropsychologist in Pennsylvania

• 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.

Verify at the official NPI Registry.