FRED B MCKINNEY (PH.D.) – Clinical Psychologist, NPI 1023072303

FRED B MCKINNEY (PH.D.) is a healthcare provider. based in Media, Pennsylvania. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. PS-002595-L (PA). The NPI Number for FRED B MCKINNEY (PH.D.) is 1023072303

Main info

Male
53 Years Of Experience
Accepts Medicare Assignment
Name
FRED B MCKINNEY (PH.D.)
NPI
1023072303
Phone
(484) 442-8049
Address
1295 N PROVIDENCE RD
Enumeration Date
14 April 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6106268085
Graduation Year
1973 (53 years ago)
PAC ID
5799710349
Group Practice PAC ID
9133483688
Professional Enrollment ID
I20051003000170
Address ID
PA190083510BR2002XRDXX303
Telehealth
Yes
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

1,668 CLINICAL PSYCHOLOGIST in PA

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Provider Addresses for FRED B MCKINNEY (PH.D.)

  • North Providence Road, Media, Delaware County, Pennsylvania, 19063, United States

    APT. G301

    MEDIA, PA 190631234

    Phone: (484) 442-8049

    Type: Mailing

  • 1489, Baltimore Pike, Springfield Township, Delaware County, Pennsylvania, 19064, United States

    BUILDING 200 SUITE 250

    SPRINGFIELD, PA 190643958

    Phone: (610) 544-2110

    Type: Location

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: 2005-10-03

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
I20051003000170IClinical PsychologistPATBD

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 19063)

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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: 9133483688View full group profile
NameSpecialtyState
Clinical Social WorkerPA
Nurse PractitionerPA
Marriage And Family TherapistPA
Clinical PsychologistPA
Clinical Social WorkerPA
Nurse PractitionerPA

Reviews

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Frequently asked questions

How is FRED B MCKINNEY (PH.D.) identified in CMS data?
CMS-hosted NPPES data lists FRED B MCKINNEY (PH.D.) with NPI 1023072303.
Is FRED B MCKINNEY (PH.D.) listed as active for patients and plans?
The listing shows FRED B MCKINNEY (PH.D.) as active in the NPI system.
What is FRED B MCKINNEY (PH.D.) best known for clinically?
Directory data describes FRED B MCKINNEY (PH.D.) with Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Does FRED B MCKINNEY (PH.D.) list a practice location?
Patients near Media, Pennsylvania may find FRED B MCKINNEY (PH.D.) in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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