Individual provider Active NPI

Michael Feinberg, MD, PHD

  • Psychiatry Physician
  • Bala Cynwyd, PA
National Provider Identifier
1972508612
Registry record updated Feb 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD-035853-E Issued in PA
Practice address
11 Bala Ave
Bala Cynwyd, PA 19004-3201
Phone
(215) 327-1565
Fax
(610) 664-5599
NPI assigned
Jun 17, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD-035853-E PA Primary
Psychiatry Physician 2084P0800X 4301034021 MI

Addresses

Primary practice location

11 Bala Ave
Bala Cynwyd, PA 19004-3201

Mailing address

7105 McCallum St
Philadelphia, PA 19119-2936
Phone (215) 248-0980

Other identifiers 1

IdentifierTypeStateIssuer
1053573MedicaidPA

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160714000117 PA Order and Referring Only - PsychiatryPractitioner - Psychiatry 8729030770

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301034021MIMDPsychiatry Physician
MD-035853-EPAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ephrata Community Hospital Past Accepting new patients
Mercy Catholic Medical Center of Southeastern PA Past Accepting new patients
Mercy Catholic Medical Center of Southeastern,PA Past Accepting new patients

Organizations & group practices 3

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265932800000",
    "number": "1972508612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7105 MCCALLUM ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191192936",
            "telephone_number": "215-248-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BALA AVE",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190043201",
            "telephone_number": "215-327-1565",
            "fax_number": "610-664-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEINBERG",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2010-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD-035853-E",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301034021",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053573",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

Verify at the official NPI Registry.