Ai Ikunaga, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS016968 Issued in PA

Practice address

1518 Walnut St
Suite 607
Philadelphia, PA 19102-3419

Phone

(267) 918-1428

NPI assigned

Nov 12, 2011

Last updated

Aug 4, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Einstein Practice Plan IncGroup PAC ID 2769395896, 774 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.

• Einstein Practice Plan Inc

  dba Einstein Psychiatry Assoc

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1760434468
  Medicare reassignment Care Compare group
• Belmont Behavioral Hospital, LLC

  dba Belmont Behavioral Hospital

  • Psychiatric Hospital
  • Philadelphia, PA
  • NPI 1629468137
  Medicare reassignment NPD
• Belmont Behavioral Hospital, LLC

  dba Belmont Northeast Outpatient Program

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Philadelphia, PA
  • NPI 1346621448
  NPD

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

{
    "created_epoch": "1321056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1932486396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 WALNUT ST",
            "address_2": "SUITE 607",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191023419",
            "telephone_number": "267-918-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 WALNUT ST",
            "address_2": "SUITE 607",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191023419",
            "telephone_number": "267-918-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKUNAGA",
        "first_name": "AI",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-12",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trish Ike-Omotowa, MD
• Kirstin Ikeda, MS OTR/L
• Okwuolisa Amechi Ikediobi, M.D.
• Erkanda Plaku Ikonomi, M.D.
• Judith N Ikpah, CRNP
• Onyinyechi Ikwuegbu, DO
• Kani Ilangovan, M.D.
• Aaron Garcillano Ilano, M. D.
• Brady Iles, MD
• Phoebe Ose Natalie Ilevbare, MD

• Clinical Psychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; 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.