Samuel H Blumberg, PH.D.
Individual provider Active NPI Clinical Psychologist · Wilmington, DE
NPI 1942397955 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1942397955
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- B1-0000212 (DE)
- Practice address
- 2300 Pennsylvania Ave
Suite 4D
Wilmington, DE 19806-1392 - Phone
- (302) 652-7733
- Fax
- (302) 652-7785
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2300 Pennsylvania Ave
4D
Wilmington, DE 19806-1338
Phone 30265277335
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050726001026 | DE | Practitioner - Clinical Psychologist | 3870520331 | Practice locations: Wilmington, DE |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diane Necastro LCSW LLC | Past |
Accepting new patients | |
| Affinity Health, L.L.C. | Clinical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | B1-0000212 | DE | Yes |
Addresses
Primary practice location
2300 Pennsylvania Ave
Suite 4D
Wilmington, DE 19806-1392
Mailing address
2300 Pennsylvania Ave
Suite 4D
Wilmington, DE 19806-1392
Phone (302) 652-7733
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000030225 | Other | DE | DELAWARE PHYSICIANS CARE |
| 562511PHD | Other | DE | BCBS OF DELAWARE |
| 234736 | Other | DE | COMPSYCH |
Other providers in Wilmington, DE
- Blue Hen Physical Therapy Inc
- Christi Marie Bluemle
- Andrew Emmanuel Bluher
- David L Blumberg
- Gabriele Blumberg
- Michael L Blume
- Kamaria Bluntson
- Alexis Elaine Blyden
- Bme Therapy Associates
- Bme Therapy Associates
All providers in Wilmington, DE · Clinical Psychologist in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.