Individual provider Active NPI

Robert Mayer Pomerantz, PH.D.

  • Psychologist
  • Bala Cynwyd, PA
National Provider Identifier
1962509042
Registry record updated Dec 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS004363L Issued in PA
Practice address
35 Cornell Rd
Bala Cynwyd, PA 19004-2104
Phone
(610) 664-8519
NPI assigned
Sep 20, 2006
Last updated
Dec 22, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS004363L PA Primary

Addresses

Primary practice location

35 Cornell Rd
Bala Cynwyd, PA 19004-2104

Mailing address

35 Cornell Rd
Bala Cynwyd, PA 19004-2104
Phone (610) 664-8519

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
I20060320000678 PA Practitioner - Clinical Psychologist 6204843097 Practice locations: Bala Cynwyd, PA; Gwynedd, PA; Kennett Square, PA; West Chester, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

35 Cornell Rd
Bala Cynwyd, PA 19004-2104
Phone (610) 664-8519

700 N Franklin St
West Chester, PA 19380-2334
Phone (610) 696-5211

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS004363LPAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Behavioral Care Past Accepting new patients

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, 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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292976000000",
    "number": "1962509042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 CORNELL RD",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190042104",
            "telephone_number": "610-664-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 CORNELL RD",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190042104",
            "telephone_number": "610-664-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMERANTZ",
        "first_name": "ROBERT",
        "middle_name": "MAYER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS004363L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

Verify at the official NPI Registry.