Individual provider Active NPI

Alyssa Scholz

  • Specialist
  • Middletown, NY
National Provider Identifier
1053292508
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1913143251 Issued in NY
Practice address
384 Crystal Run Rd Ste 102
Middletown, NY 10941-4073
Phone
(845) 728-1623
NPI assigned
Sep 10, 2025
Last updated
Sep 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X
Specialist 174400000X 1913143251 NY Primary
Developmental Therapist 222Q00000X

Addresses

Primary practice location

384 Crystal Run Rd Ste 102
Middletown, NY 10941-4073

Mailing address

384 Crystal Run Rd Ste 102
Middletown, NY 10941-4073
Phone (845) 728-1623

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1913143251NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1757462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1053292508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "384 CRYSTAL RUN RD STE 102",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414073",
            "telephone_number": "845-728-1623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 CRYSTAL RUN RD STE 102",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414073",
            "telephone_number": "845-728-1623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOLZ",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-10",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1913143251",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.