Active NPI
Stephen Ira Boren, PSY.D.
- Psychologist
- Pittsburgh, PA
National Provider Identifier
1942411228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1602
- Practice address
- 401 Shady Ave
Apt. D301
Pittsburgh, PA 15206-4409 - Phone
- (301) 802-6144
- NPI assigned
- May 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1602 | MD | Primary |
Addresses
Primary practice location
401 Shady Ave
Apt. D301
Pittsburgh, PA 15206-4409
Mailing address
2002 Sproul Rd
Ste 300
Broomall, PA 19008-3510
Phone (610) 626-8085
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1602 | MD | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581552000000",
"number": "1942411228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2002 SPROUL RD",
"address_2": "STE 300",
"city": "BROOMALL",
"state": "PA",
"postal_code": "190083510",
"telephone_number": "610-626-8085",
"fax_number": "610-626-8032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 SHADY AVE",
"address_2": "APT. D301",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152064409",
"telephone_number": "301-802-6144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOREN",
"first_name": "STEPHEN",
"middle_name": "IRA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-25",
"last_updated": "2020-02-13",
"certification_date": "2020-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "1602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsburgh, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.