Organization Active NPI

Aviva Gaskill, PHD, PLLC

  • Psychologist
  • Wynnewood, PA
National Provider Identifier
1912471350
Registry record updated Jan 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
AVIVA GASKILL, PHD, PLLC
Practice address
308 East Lancaster Avenue
Suite 200
Wynnewood, PA 19096-2145
Phone
(856) 392-7692
Fax
(610) 642-3278
NPI assigned
Jan 18, 2019
Last updated
Jan 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2019

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

Authorized official

Name
Dr. Aviva Sharon Gaskill, PHD
Title
Psychologist/Owner
Phone
(856) 392-7692

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

308 East Lancaster Avenue
Suite 200
Wynnewood, PA 19096-2145

Mailing address

308 East Lancaster Avenue
Suite 200
Wynnewood, PA 19096-2145
Phone (856) 392-7692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190627002025 PA Part B Supplier - Clinic/Group Practice 8921332792 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bala Cynwyd, PA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547769600000",
    "number": "1912471350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 EAST LANCASTER AVENUE",
            "address_2": "SUITE 200",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190962145",
            "telephone_number": "856-392-7692",
            "fax_number": "610-642-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 EAST LANCASTER AVENUE",
            "address_2": "SUITE 200",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190962145",
            "telephone_number": "856-392-7692",
            "fax_number": "610-642-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVIVA GASKILL, PHD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-18",
        "last_updated": "2019-01-18",
        "status": "A",
        "authorized_official_last_name": "GASKILL",
        "authorized_official_first_name": "AVIVA",
        "authorized_official_middle_name": "SHARON",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "856-392-7692",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.