DR. ANDREW B MOUTON (PHD) – Clinical Psychologist, NPI 1477500825

DR. ANDREW B MOUTON (PHD) is a healthcare provider. based in Orland park, Illinois. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 071004325 (IL). The NPI Number for DR. ANDREW B MOUTON (PHD) is 1477500825

Main info

Male
37 Years Of Experience
Accepts Medicare Assignment
Name
DR. ANDREW B MOUTON (PHD)
NPI
1477500825
Phone
(708) 364-0261
Address
10640 W 165TH STREET
Enumeration Date
30 May 2006
Last Update Date
13 May 2009

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7083640261
Graduation Year
1989 (37 years ago)
PAC ID
9133022866
Group Practice PAC ID
2961305693
Professional Enrollment ID
I20040202000455
Address ID
IL604678734OR10640STXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,600 CLINICAL PSYCHOLOGIST in IL

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Provider Addresses for DR. ANDREW B MOUTON (PHD)

  • 165th Street, Alpine, Orland Park, Orland Township, Cook County, Illinois, 60467, United States

    ORLAND PARK, IL 604675653

    Phone: (708) 364-0261

    Fax: (708) 364-6019

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-02-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040202000455IClinical PsychologistILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60467)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2961305693View full group profile
NameSpecialtyState
Nurse PractitionerIL
Clinical PsychologistIL
-IL
-IL
-IL
Physician AssistantIL
Nurse PractitionerIL
Physician AssistantIL
Nurse PractitionerIL
Physician AssistantIL

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Frequently asked questions

What unique ID ties claims to DR. ANDREW B MOUTON (PHD)?
NPI 1477500825 is assigned to DR. ANDREW B MOUTON (PHD) under the national enumeration system.
Is DR. ANDREW B MOUTON (PHD) currently active in the NPI registry?
CMS-published data lists DR. ANDREW B MOUTON (PHD) as an active registrant.
What field does DR. ANDREW B MOUTON (PHD) work in?
You can think of DR. ANDREW B MOUTON (PHD) as practicing within Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Where does public data place DR. ANDREW B MOUTON (PHD)?
The snapshot lists Orland Park, Illinois for DR. ANDREW B MOUTON (PHD); download NPPES for the complete set.
How can I contact DR. ANDREW B MOUTON (PHD)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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