Active NPI
Michael Dahl
- Psychologist
- Rochester, NY
National Provider Identifier
1053819656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 007550-1
- Practice address
- 1111 Elmwood Ave
Rochester, NY 14620-3005 - Phone
- (585) 241-1691
- NPI assigned
- Jan 29, 2018
- Last updated
- Jan 29, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 007550-1 | NY | Primary |
Addresses
Primary practice location
1111 Elmwood Ave
Rochester, NY 14620-3005
Mailing address
1111 Elmwood Ave
Rochester, NY 14620-3005
Phone (585) 241-1691
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007550 | NY | MD | Mental Health Counselor |
| 007550-1 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517184000000",
"number": "1053819656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 ELMWOOD AVE",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146203005",
"telephone_number": "585-241-1691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 ELMWOOD AVE",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146203005",
"telephone_number": "585-241-1691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAHL",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-29",
"last_updated": "2018-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "007550-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
- Amy F Daggett, ANP
- Carol S Dagostino, LCSW
- Seema G Dahake, MD
- Ala Dahhan, M.D
- Roopali Dahiya, MBBS, MD
- Spencer Katmai Dahl
- Dahla-Ortiz Professional Healthcare Consultation PLLC
- Dahla-Ortiz Professional Healthcare Consultation PLLC
- Dahla-Ortiz Professional Healthcare Consultation PLLC
- Dahla-Ortiz Professional Healthcare Consultation PLLC (Dahla-Ortiz Professional Healthcare Professional Consultation PLLC)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; 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.