Individual provider Active NPI

Cheryl S Tucker, PHD

  • Psychologist
  • New York, NY
National Provider Identifier
1023007051
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
009443 Issued in NY
Practice address
160 W 62ND St Apt 29C
New York, NY 10023-7534
Phone
(518) 744-4161
NPI assigned
Oct 21, 2005
Last updated
Dec 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 009443 NY Primary

Addresses

Primary practice location

160 W 62ND St Apt 29C
New York, NY 10023-7534

Mailing address

160 W 62ND St Apt 29C
New York, NY 10023-7534
Phone (518) 744-4161

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
I20070926000636 NY Practitioner - Clinical Psychologist 4284729989 Reassigns benefits to 1 organization
Practice locations: Lake George, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009443NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Healthcare Services PLLC Current Accepting new patients
Hospitalist Healthcare Services PLLC CurrentSince Aug 3, 2015 Accepting new patients
Hospitalist Healthcare Services PLLC CurrentSince Aug 3, 2015 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

420 E 76th St
New York, NY 10021
Phone (212) 434-5300

2902 Upper Tibbits Ave
Troy, NY 12180
Phone (518) 273-2040

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
High Peaks Hospice and Palliative Care, Inc.Saranac Lake, NY, CCN 331531 Hospice Corporate Officer Oct 22, 2008

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1023007051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 W 62ND ST APT 29C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237534",
            "telephone_number": "518-744-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 W 62ND ST APT 29C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237534",
            "telephone_number": "518-744-4161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "CHERYL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-21",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "009443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.