Individual provider Active NPI

Elizabeth Ryan, PHD

  • Clinical Neuropsychologist
  • New York, NY
National Provider Identifier
1043357593
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
013982 Issued in NY
Practice address
641 Lexington Ave FL 7
New York, NY 10022-4503
Phone
(646) 888-0044
Fax
(212) 888-2384
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 013982 NY Primary

Addresses

Primary practice location

641 Lexington Ave FL 7
New York, NY 10022-4503

Mailing address

641 Lexington Ave FL 7
New York, NY 10022-4503
Phone (646) 888-0044

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
I20090320000428 NY Practitioner - Clinical Psychologist 6608933536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Washington University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Psychiatry GroupGroup PAC ID 2062301476, 50 clinicians

Practice addresses (Care Compare)

205 E 64TH St
New York, NY 10065-6635
Phone (646) 449-1000

Merit-based Incentive Payment System (MIPS)

Final score
73.61 of 100Reported as group
Quality
70.88
Improvement activities
40
Cost
46.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013982NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Psychiatry Group CurrentSince Feb 27, 2009 Accepting new patients
Ralph Lauren Center for Cancer Care and Prevention PastSince Dec 1, 2019 Accepting new patients

Locations

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

641 Lexington Ave
Fl 7
New York, NY 10022
Phone (646) 888-0098

205 E 64th St
New York, NY 10065
Phone (212) 639-3127

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1043357593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 LEXINGTON AVE FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100224503",
            "telephone_number": "646-888-0044",
            "fax_number": "212-888-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 LEXINGTON AVE FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100224503",
            "telephone_number": "646-888-0044",
            "fax_number": "212-888-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "013982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.