Individual provider Active NPI

Patricia M Moylan, PHD

  • Clinical Neuropsychologist
  • Farmington Hills, MI
National Provider Identifier
1952496333
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
6301006253 Issued in MI
Practice address
28595 Orchard Lake Rd.
Ste. 125
Farmington Hills, MI 48167
Phone
(248) 553-2558
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 6301006253 MI Primary

Addresses

Primary practice location

28595 Orchard Lake Rd.
Ste. 125
Farmington Hills, MI 48167

Mailing address

28595 Orchard Lake Rd.
Ste. 125
Farmington Hills, MI 48167
Phone (248) 553-2558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20070326000433 MI Practitioner - Clinical Psychologist 0749384022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alpha Psychological Services PCGroup PAC ID 5395749147, 3 clinicians

Practice addresses (Care Compare)

41820 6 Mile Rd
Suite 104
Northville, MI 48168-2771
Phone (248) 349-3131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301006253MIMDClinical Neuropsychologist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952496333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28595 ORCHARD LAKE RD.",
            "address_2": "STE. 125",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "48167",
            "telephone_number": "248-553-2558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28595 ORCHARD LAKE RD.",
            "address_2": "STE. 125",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "48167",
            "telephone_number": "248-553-2558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYLAN",
        "first_name": "PATRICIA",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "6301006253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.