Individual provider Active NPI

Karen Dybner-Madero, PSYD

  • Psychologist
  • Philadelphia, PA
National Provider Identifier
1912518226
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS009148L Issued in PA
Practice address
2201 Pennsylvania Avenue
The Parkway House, Suite 101
Philadelphia, PA 19130
Phone
(215) 636-0887
NPI assigned
Aug 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 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 PS009148L PA Primary

Addresses

Primary practice location

2201 Pennsylvania Avenue
The Parkway House, Suite 101
Philadelphia, PA 19130

Mailing address

436 Old Lancaster Rd
Haverford, PA 19041-1518

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PS009148LPAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1912518226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 OLD LANCASTER RD",
            "city": "HAVERFORD",
            "state": "PA",
            "postal_code": "190411518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 PENNSYLVANIA AVENUE",
            "address_2": "THE PARKWAY HOUSE, SUITE 101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19130",
            "telephone_number": "215-636-0887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYBNER-MADERO",
        "first_name": "KAREN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS009148L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.