Individual provider Active NPI

Jared Muskin Shiff, PSY.D.

  • Clinical Psychologist
  • Long Beach, NY
National Provider Identifier
1013684554
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
024393 Issued in NY
Practice address
136 E Olive St
Long Beach, NY 11561-3509
Phone
(516) 425-3807
NPI assigned
Aug 24, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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 024393 NY Primary

Addresses

Primary practice location

136 E Olive St
Long Beach, NY 11561-3509

Mailing address

136 E Olive St
Long Beach, NY 11561-3509
Phone (516) 425-3807

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
I20220610001299 NY Practitioner - Clinical Psychologist 4486032083 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2022 Accepting new patients

Locations

1425 Madison Ave
New York, NY 10029
Phone (212) 824-8150

150 E 42nd St
Fl 2
New York, NY 10017
Phone (646) 605-8119

Organizations & group practices 2

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": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1013684554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 E OLIVE ST",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613509",
            "telephone_number": "516-425-3807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 E OLIVE ST",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613509",
            "telephone_number": "516-425-3807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIFF",
        "first_name": "JARED",
        "middle_name": "MUSKIN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, NY

Sources for this page

Verify at the official NPI Registry.