DR. JAY IRA WEISSMAN (PH.D.) – Clinical Psychologist, NPI 1104986454

DR. JAY IRA WEISSMAN (PH.D.) is a healthcare provider. based in Newtown square, Pennsylvania. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. PS 005215 L (PA). The NPI Number for DR. JAY IRA WEISSMAN (PH.D.) is 1104986454

Main info

Male
Sole Proprietor
33 Years Of Experience
Accepts Medicare Assignment
Name
DR. JAY IRA WEISSMAN (PH.D.)
NPI
1104986454
Phone
(610) 356-3724
Address
12B SMEDLEY LN
Enumeration Date
9 December 2006
Last Update Date
9 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6103563724
Graduation Year
1993 (33 years ago)
PAC ID
4880726025
Professional Enrollment ID
I20101112000052
Address ID
PA190733206NESUITESUIT101
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:19State licenses:2Digital endpointsOther names

1,674 CLINICAL PSYCHOLOGIST in PA

Provider Addresses for DR. JAY IRA WEISSMAN (PH.D.)

  • 12B SMEDLEY LN

    SUITE 1

    NEWTOWN SQUARE, PA 190733206

    Phone: (610) 356-3724

    Fax: (610) 658-0927

    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: 2010-11-12

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20100723000063IClinical PsychologistDETBD
I20101112000052IClinical 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 19073)

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Reviews

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Frequently asked questions

What federal number belongs to DR. JAY IRA WEISSMAN (PH.D.)?
The federal identifier for DR. JAY IRA WEISSMAN (PH.D.) is NPI 1104986454.
Is DR. JAY IRA WEISSMAN (PH.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does DR. JAY IRA WEISSMAN (PH.D.) treat or focus on?
Patients typically see DR. JAY IRA WEISSMAN (PH.D.) under the specialty Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Where is DR. JAY IRA WEISSMAN (PH.D.)'s primary listing?
We display Newtown Square, Pennsylvania because that is what the record indicates for DR. JAY IRA WEISSMAN (PH.D.).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.