MR. THEODORE JOSEPH GRADMAN PH.D.
NPI 1467666420
Psychologist - Cognitive & Behavioral in San Mateo, CA
About Mr. Theodore Joseph Gradman Ph.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. THEODORE JOSEPH GRADMAN PH.D. (NPI 1467666420) is an individual cognitive & behavioral provider in San Mateo, California, licensed in California (PSY12044) and active in the NPI registry since May 2007. He has opted out of Medicare through April 1, 2028 and remains eligible to order and refer.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Mr. Theodore Joseph Gradman Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2016 through April 1, 2028.
Other Providers at the Same Location NPPES 10
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN MATEO, CA 94401
SAN MATEO, CA 94401
SAN MATEO, CA 94401
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Theodore Gradman's NPI number?
The NPI number for Theodore Gradman is 1467666420. It was assigned to this individual provider in the NPPES registry on May 9, 2007.
Where is Theodore Gradman located?
Theodore Gradman practices at 327 N San Mateo Dr Suite 3, San Mateo, CA 94401. The listed phone number is (650) 340-0243.
What is Theodore Gradman's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Cognitive & Behavioral, with taxonomy code 103TB0200X.
Is Theodore Gradman enrolled in Medicare?
No. Theodore Gradman has opted out of Medicare through April 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
When was this NPI record last updated?
The NPPES record for Theodore Gradman was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mr. Theodore Joseph Gradman, PH.D. · NPI 1467666420
Cognitive & Behavioral provider in San Mateo, California. Individual provider, active in the CMS NPPES registry since May 9, 2007.
## Identity
- **NPI:** 1467666420 (Entity type: Individual)
- **Enumerated:** May 9, 2007
- **Primary specialty:** Psychologist - Cognitive & Behavioral · taxonomy 103TB0200X
- **State license:** PSY12044 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 327 N SAN MATEO DR, SUITE 3, San Mateo, CA 94401-2585
- **Phone:** (650) 340-0243
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through April 1, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** July 8, 2007
- **Other identifiers:** Medicare ID-Type Unspecified PSY120440 (CA)
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Source: [NPI Profile](https://npiprofile.com/npi/1467666420) · Data from the CMS NPPES public registry.