Active NPI
Shoshana D. Beran, PSYD
- Clinical Psychologist
- Mesa, AZ
National Provider Identifier
1043573611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 01939201
- Practice address
- 1910 S Stapley Dr Ste 221
Mesa, AZ 85204-6680 - Phone
- (914) 362-1083
- NPI assigned
- Jun 19, 2012
- Last updated
- Dec 11, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 01939201 | NY | Primary |
Addresses
Primary practice location
1910 S Stapley Dr Ste 221
Mesa, AZ 85204-6680
Mailing address
754 W Henderson LN
Gilbert, AZ 85233-5348
Phone (914) 362-1083
Other practice location 1
100 S Bedford Rd Ste 340
Mount Kisco, NY 10549-3444
Phone (914) 362-1083
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 |
|---|---|---|---|
| 01939201 | NY | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Humphries Third, LLC | Current | Accepting new patients | |
| Hypnoscope Medical, PC | Past | Accepting new patients |
Locations
100 S Bedford Rd
Ste 340
Mount Kisco, NY 10549
Phone (914) 200-2512
Interoperability endpoints
- cpa.shoshanabernan@142175.advancedmd-direct.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Shoshana Beran, Psy.D.
- Adult Mental Health Clinic/Center
- Mount Kisco, NY
- NPI 1407421712
-
- Specialist
- Carmel, NY
- NPI 1093024606
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702252800000",
"number": "1043573611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "754 W HENDERSON LN",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852335348",
"telephone_number": "914-362-1083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1910 S STAPLEY DR STE 221",
"city": "MESA",
"state": "AZ",
"postal_code": "852046680",
"telephone_number": "914-362-1083"
}
],
"practiceLocations": [
{
"address_1": "100 S Bedford Rd Ste 340",
"address_purpose": "LOCATION",
"city": "Mount Kisco",
"state": "NY",
"postal_code": "105493444",
"country_code": "US",
"telephone_number": "914-362-1083",
"fax_number": "914-867-2208",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BERAN",
"first_name": "SHOSHANA",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-19",
"last_updated": "2023-12-11",
"certification_date": "2023-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "01939201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.