Individual provider Active NPI

Stephen Ira Hyman, PH.D.

  • Clinical Psychologist
  • Roslyn Heights, NY
National Provider Identifier
1013063395
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3852 Issued in NY
Practice address
68 Shadetree LN
Roslyn Heights, NY 11577-2503
Phone
(516) 484-0909
Fax
(516) 621-3071
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 3852 NY Primary

Addresses

Primary practice location

68 Shadetree LN
Roslyn Heights, NY 11577-2503

Mailing address

68 Shadetree LN
Roslyn Heights, NY 11577-2503
Phone (516) 484-0909

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
I20110113001136 NY Practitioner - Clinical Psychologist 3375732837 Practice locations: Roslyn Heights, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

68 Shadetree LN
Roslyn Heights, NY 11577-2503
Phone (516) 484-0909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
003852NYMDMental Health Counselor
3852NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013063395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 SHADETREE LN",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772503",
            "telephone_number": "516-484-0909",
            "fax_number": "516-621-3071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 SHADETREE LN",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772503",
            "telephone_number": "516-484-0909",
            "fax_number": "516-621-3071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYMAN",
        "first_name": "STEPHEN",
        "middle_name": "IRA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "3852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn Heights, NY

Sources for this page

Verify at the official NPI Registry.