Mark Edwin Kovaleski, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

009697 Issued in NY

Practice address

3 Tioga Blvd
Suite 5
Apalachin, NY 13732-4150

Phone

(607) 785-4156

Fax

(607) 625-4438

NPI assigned

Oct 5, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Birmingham Medical College, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033205497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 TIOGA BLVD",
            "address_2": "SUITE 5",
            "city": "APALACHIN",
            "state": "NY",
            "postal_code": "137324150",
            "telephone_number": "607-785-4156",
            "fax_number": "607-625-4438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 TIOGA BLVD",
            "address_2": "SUITE 5",
            "city": "APALACHIN",
            "state": "NY",
            "postal_code": "137324150",
            "telephone_number": "607-785-4156",
            "fax_number": "607-625-4438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVALESKI",
        "first_name": "MARK",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "009697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jump Start Physical Therapy, PLLC
• Edward Mathias Kamin Jr., PH.D.
• Trupti M Kaneria, PHYSICAL THERAPIST
• Kristin Veronica Kinney, M.S. CCC-SLP
• Jaclyn Kisloski, M.S., CCC-SLP
• Jaysukh Mohanbhai Lalkiya, RPH
• Anne M Laubisch, COTA/L
• Stephanie Barbara Lockshin, PH.D.
• Elizabeth G Long, APRN-BC
• Mattie Anne Lucas, PTA

• Clinical Psychologist in Apalachin, NY
• Providers in Apalachin, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.