Individual provider Active NPI

Dianne Marino-Surovcik, PHD

  • Clinical Psychologist
  • Hellertown, PA
National Provider Identifier
1982668570
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS009188L Issued in PA
Practice address
175 W Butternut Rd
Hellertown, PA 18055-9712
Phone
(484) 851-3486
NPI assigned
Apr 12, 2006
Last updated
May 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS009188L PA Primary

Addresses

Primary practice location

175 W Butternut Rd
Hellertown, PA 18055-9712

Mailing address

175 W Butternut Rd
Hellertown, PA 18055-9712
Phone (484) 851-3486

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
I20051208000562 PA Practitioner - Clinical Psychologist 1759323991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

175 W Butternut Rd
Hellertown, PA 18055-9712

800 Main St
Suite 106
Hellertown, PA 18055-1535
Phone (484) 851-3486

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS009188LPAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dianne Marino Surovcik PHD Dba DMS Psychological Services, LLC Clinical CurrentSince Nov 12, 2012 Accepting new patients
Kimberly Gentempo-McAllister Pys D LLC Psychologist CurrentSince Oct 3, 2024 Accepting new patients
Hellertown Family Foot Care, Inc. Past Accepting new patients

Locations

42 Main St
Hellertown, PA 18055
Phone (484) 896-0493

800 Main St
Ste 106
Hellertown, PA 18055
Phone (484) 851-3486

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, 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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1982668570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 W BUTTERNUT RD",
            "city": "HELLERTOWN",
            "state": "PA",
            "postal_code": "180559712",
            "telephone_number": "484-851-3486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 W BUTTERNUT RD",
            "city": "HELLERTOWN",
            "state": "PA",
            "postal_code": "180559712",
            "telephone_number": "484-851-3486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO-SUROVCIK",
        "first_name": "DIANNE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS009188L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hellertown, PA

Sources for this page

Verify at the official NPI Registry.