Active NPI
Candace Clark Martin, PH.D.
- Psychologist
- New York, NY
National Provider Identifier
1043435860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 010493
- Practice address
- 470 W End Ave # 1Aa
New York, NY 10024-4933 - Phone
- (212) 877-3231
- NPI assigned
- Apr 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 010493 | NY | Primary |
Addresses
Primary practice location
470 W End Ave # 1Aa
New York, NY 10024-4933
Mailing address
470 W End Ave
Suite 1Aa
New York, NY 10024-4933
Phone (212) 877-3231
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111130000367 | NY | Practitioner - Clinical Psychologist | 9436323532 | Practice locations: New York, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
470 W End Ave
1Aa
New York, NY 10024-4933
Phone (212) 877-3231
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010493 | NY | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320364800000",
"number": "1043435860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "470 W END AVE",
"address_2": "SUITE 1AA",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100244933",
"telephone_number": "212-877-3231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "470 W END AVE # 1AA",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100244933",
"telephone_number": "212-877-3231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "CANDACE",
"middle_name": "CLARK",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-16",
"last_updated": "2011-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "010493",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; 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.