MARY PELHAM (PSY.D) – Clinical Neuropsychologist, NPI 1902944432

MARY PELHAM (PSY.D) is a healthcare provider. based in Phila, Pennsylvania. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSY.D. They hold a License No. PS015401 (PA). The NPI Number for MARY PELHAM (PSY.D) is 1902944432

Main info

Female
25 Years Of Experience
Accepts Medicare Assignment
Name
MARY PELHAM (PSY.D)
NPI
1902944432
Phone
(215) 254-2630
Address
101 E OLNEY AVE
Enumeration Date
5 February 2007
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2154569900
Graduation Year
2001 (25 years ago)
PAC ID
3375512049
Group Practice PAC ID
3971412297
Professional Enrollment ID
I20040929000596
Address ID
PA191413019PH1200XRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,669 CLINICAL PSYCHOLOGIST in PA

Provider Addresses for MARY PELHAM (PSY.D)

  • 101 E OLNEY AVE

    SUITE 505

    PHILA, PA 191202421

    Phone: (215) 254-2630

    Fax: (215) 254-2599

    Type: Mailing

  • 60 TOWNSHIP LINE RD

    MOSS REHAB

    ELKINS PARK, PA 190272220

    Phone: (215) 663-6270

    Fax: (215) 663-6739

    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: 2004-09-29

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
I20040929000596IClinical 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
96158Treatment of behavior impacting health, initial 30 minutes5638$0
96156Assessment of health behavior5350$0
96159Treatment of behavior impacting health, each additional 15 minutes1813$0
View full utilization report →

Insurance plans in this area (ZIP 19120)

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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: 3971412297View full group profile
NameSpecialtyState
Clinical PsychologistPA
-PA
Clinical PsychologistPA
Clinical PsychologistPA
Clinical PsychologistPA

Reviews

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Frequently asked questions

What identifier follows MARY PELHAM (PSY.D) across health systems?
The NPI 1902944432 uniquely identifies MARY PELHAM (PSY.D) in U.S. healthcare data.
Should I treat MARY PELHAM (PSY.D) as an active provider?
Patients and plans typically see MARY PELHAM (PSY.D) as active in the national extract.
What does the directory say MARY PELHAM (PSY.D) does?
Insurance directories may phrase it differently, but here MARY PELHAM (PSY.D) maps to Clinical Neuropsychologist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to MARY PELHAM (PSY.D)?
MARY PELHAM (PSY.D) is associated with Phila, Pennsylvania in the same public data insurers reference.
Who maintains MARY PELHAM (PSY.D)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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