Individual provider Active NPI

Carl Fischer

  • Psychologist
  • Willow Grove, PA
National Provider Identifier
1962911792
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS018901 Issued in PA
Practice address
2300 Computer Rd Ste C15
Willow Grove, PA 19090-1735
Phone
(484) 440-9740
NPI assigned
Sep 25, 2017
Last updated
Sep 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS018901 PA Primary

Addresses

Primary practice location

2300 Computer Rd Ste C15
Willow Grove, PA 19090-1735

Mailing address

2300 Computer Rd Ste C15
Willow Grove, PA 19090-1735
Phone (484) 440-9740

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
I20241212001477 PA Practitioner - Clinical Psychologist 7113453283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vista Medical Services IncGroup PAC ID 5597743344, 31 clinicians

Practice addresses (Care Compare)

1001 Wallace St
Tucker Nursing Home
Philadelphia, PA 19123-2599
Phone (215) 235-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Medical Services, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Dragonfly Psychological Associates PastSince Sep 25, 2019 Accepting new patients

Locations

160 Rock Hill Rd
Bala Cynwyd, PA 19004
Phone (610) 667-6080

160 Rock Hill Rd
Fl 1
Bala Cynwyd, PA 19004
Phone (610) 667-5460

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": "1506297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1962911792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 COMPUTER RD STE C15",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901735",
            "telephone_number": "484-440-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 COMPUTER RD STE C15",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901735",
            "telephone_number": "484-440-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "CARL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-25",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS018901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Grove, PA

Sources for this page

Verify at the official NPI Registry.