Latha V Soorya, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0161410 Issued in NY

Practice address

1428 Madison Ave
Department of Psychiatry, Box 1230
New York, NY 10029-6508

Phone

(212) 241-7250

Fax

(212) 241-5670

NPI assigned

Oct 6, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lsoorya85294@direct.rush.rush-health.com

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.

• Rush University Medical Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542

  Clinical

  Medicare reassignment NPD
• Rush University Medical Center

  • Diagnostic Radiology Physician
  • Chicago, IL
  • NPI 1184269425
  NPD

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

{
    "created_epoch": "1286323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286323200000",
    "number": "1053620120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 MADISON AVE",
            "address_2": "DEPARTMENT OF PSYCHIATRY, BOX 1230",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296508",
            "telephone_number": "212-241-7250",
            "fax_number": "212-241-5670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 MADISON AVE",
            "address_2": "DEPARTMENT OF PSYCHIATRY, BOX 1230",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296508",
            "telephone_number": "212-241-7250",
            "fax_number": "212-241-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOORYA",
        "first_name": "LATHA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-06",
        "last_updated": "2010-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-02-0857",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "0161410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sohail Sookram, PHYSICIAN ASSISTANT
• Sookwook Lee MD PC
• Irfana Haq Soomro, M.D
• Melissa Soong, LMSW
• Prasanna Sooriakumaran, MD, PHD
• Aviva Bracha Sopher, M.D., M.S.
• Rachel Sopher, LCSW
• Sophia Aslanis Rd, CDN, LLC
• Sophie a Greenberg MD PLLC
• Sophie Young Acupuncture PLLC

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.