Active NPI
Jonathan Leonard Kanegson, PSY.D.
- Clinical Psychologist
- New York, NY
National Provider Identifier
1043489339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 017102
- Practice address
- 19 W 34TH St
Sociometric Institute- PH Floor
New York, NY 10001-3006 - Phone
- (212) 947-7111
- NPI assigned
- Feb 21, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Clinical Psychologist | 103TC0700X | 21681 | CA | |
| Clinical Psychologist | 103TC0700X | 8810 | MA | |
| Clinical Psychologist | 103TC0700X | PY9535 | FL | |
| Clinical Psychologist | 103TC0700X | 017102 | NY | Primary |
Addresses
Primary practice location
19 W 34TH St
Sociometric Institute- PH Floor
New York, NY 10001-3006
Mailing address
239 E 88TH St Apt 4
New York, NY 10128-0907
Phone (646) 634-5080
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 435284 | Other | MHN | |
| 10433489339 | Other | NY | VALUE OPTIONS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY9535 | FL | MD | Clinical Psychologist |
| 8810 | MA | MD | Sports Physical Therapist |
| 21681 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686614400000",
"number": "1043489339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "239 E 88TH ST APT 4",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101280907",
"telephone_number": "646-634-5080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 W 34TH ST",
"address_2": "SOCIOMETRIC INSTITUTE- PH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100013006",
"telephone_number": "212-947-7111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANEGSON",
"first_name": "JONATHAN",
"middle_name": "LEONARD",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-21",
"last_updated": "2023-06-13",
"certification_date": "2023-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "21681",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "8810",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY9535",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "017102",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN",
"identifier": "435284",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "10433489339",
"state": "NY"
}
],
"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 Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.