Individual provider Active NPI

Michael Thomas Mosko, PSY.D.

  • Clinical Psychologist
  • Wyomissing, PA
National Provider Identifier
1942316393
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS016152 Issued in PA
Practice address
938 Penn Ave
Wyomissing, PA 19610-3017
Phone
(610) 372-0466
NPI assigned
Aug 21, 2006
Last updated
May 20, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS016152 PA Primary

Addresses

Primary practice location

938 Penn Ave
Wyomissing, PA 19610-3017

Mailing address

100 S 7TH Ave
West Reading, PA 19611-1022
Phone (610) 413-6889

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20071113000575 PA Practitioner - Clinical Psychologist 4486665122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

122 W Lancaster Ave
Suite 107
Shillington, PA 19607-1874
Phone (610) 413-6889

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS016152PAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamics Psychological Services, LLC Clinical CurrentSince Dec 15, 2019 Accepting new patients
Peter H. Thomasph.D. and Associates Clinical Past Accepting new patients

Locations

122 W Lancaster Ave
Ste 107
Shillington, PA 19607
Phone (610) 413-6889

122 W Lancaster Ave
Ste 202
Shillington, PA 19607
Phone (610) 413-6889

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1942316393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S 7TH AVE",
            "city": "WEST READING",
            "state": "PA",
            "postal_code": "196111022",
            "telephone_number": "610-413-6889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "938 PENN AVE",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103017",
            "telephone_number": "610-372-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSKO",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.