NPIMap

Individual provider Active NPI

Molly Tanenbaum, PHD

  • Clinical Psychologist
  • Palo Alto, CA
National Provider Identifier
1982912028
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY29228 Issued in CA
Practice address
730 Welch Rd
Palo Alto, CA 94304-1503
Phone
(650) 724-3033
NPI assigned
Sep 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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 PSY29228 CA Primary

Addresses

Primary practice location

730 Welch Rd
Palo Alto, CA 94304-1503

Mailing address

780 Welch Rd # Mc5776
Palo Alto, CA 94304-1516
Phone (650) 725-3955

Other practice location 1

5676 Riverdale Ave
Ste 202
Bronx, NY 10471-2138
Phone (718) 796-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170817003426 CA Practitioner - Clinical Psychologist 1456623958 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians

Practice addresses (Care Compare)

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Hospital & facility affiliations

  • Stanford Health Care Hospital, Stanford, CA, CCN 050441

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
87.08
Promoting interoperability
100
Improvement activities
40
Cost
69.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY29228CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care CurrentSince Jul 2, 2017 Accepting new patients
Stanford Health Care CurrentSince Jul 2, 2017 Accepting new patients
LPCH Medical Group Div of Lucile CurrentSince Jul 2, 2017 Accepting new patients
Stanford Health Care Current Accepting new patients

Locations

1804 Embarcadero Rd
Ste 100
Palo Alto, CA 94303
Phone (650) 497-9067

730 Welch Rd
Palo Alto, CA 94304
Phone (650) 723-4800

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

780 Welch Rd
#5776
Palo Alto, CA 94304
Phone (650) 215-0732

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Organizations & group practices 4

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1982912028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 WELCH RD # MC5776",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041516",
            "telephone_number": "650-725-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041503",
            "telephone_number": "650-724-3033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5676 Riverdale Ave",
            "address_2": "Ste 202",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104712138",
            "country_code": "US",
            "telephone_number": "718-796-5300",
            "fax_number": "718-548-1161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANENBAUM",
        "first_name": "MOLLY",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-23",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY29228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.