Individual provider Active NPI

Daniel N Guerra, PSYD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1003835810
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
014289 Issued in NY
Practice address
280 Madison Ave
RM 1403
New York, NY 10016-0801
Phone
(917) 566-3840
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 014289 NY Primary

Addresses

Primary practice location

280 Madison Ave
RM 1403
New York, NY 10016-0801

Mailing address

280 Madison Ave
RM 1403
New York, NY 10016-0801
Phone (917) 566-3840

Other practice location 1

21 Old Main St Ste 204
Fishkill, NY 12524-1883
Phone (917) 566-3840

Other identifiers 1

IdentifierTypeStateIssuer
02356036MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050330000939 NY Practitioner - Clinical Psychologist 2961454558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

280 Madison Ave
RM 1403
New York, NY 10016-0801
Phone (917) 566-3840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Stress Management Services PC Clinical CurrentSince Mar 12, 2003 Accepting new patients

Locations

10 Plaza St E
Ste 1C
Brooklyn, NY 11238
Phone (718) 570-7701

21 Old Main St
Ste 204
Fishkill, NY 12524
Phone (845) 897-4100

280 Madison Ave
Rm 1403
New York, NY 10016
Phone (212) 534-7099

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1003835810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 MADISON AVE",
            "address_2": "RM 1403",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160801",
            "telephone_number": "917-566-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 MADISON AVE",
            "address_2": "RM 1403",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160801",
            "telephone_number": "917-566-3840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Old Main St Ste 204",
            "address_purpose": "LOCATION",
            "city": "Fishkill",
            "state": "NY",
            "postal_code": "125241883",
            "country_code": "US",
            "telephone_number": "917-566-3840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUERRA",
        "first_name": "DANIEL",
        "middle_name": "N",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "014289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02356036",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.