Individual provider Active NPI

Melissa Sable, PHD

  • Psychologist
  • Bath, NY
National Provider Identifier
1063662120
Registry record updated Jan 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
02056 Issued in NY
Practice address
76 Veterans Ave
Bath, NY 14810-0810
Phone
(607) 664-4000
Fax
(607) 664-4341
NPI assigned
Sep 25, 2008
Last updated
Jan 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 02056 NY Primary

Addresses

Primary practice location

76 Veterans Ave
Bath, NY 14810-0810

Mailing address

76 Veterans Ave
Bath, NY 14810-0810
Phone (607) 664-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20201103001481 NY Practitioner - Clinical Psychologist 9234549247 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Che Senior Psychological Services, PCGroup PAC ID 8022905314, 227 clinicians

Practice addresses (Care Compare)

135 Vanderbilt Ave
Staten Island, NY 10304-2604
Phone (800) 275-3243

250 Beach 17TH St
Far Rockaway, NY 11691-4420
Phone (800) 275-3243

447 -449 Lake Shore Dr W
Absolut Care of Dunkirk Nurs
Dunkirk, NY 14048-1479
Phone (800) 275-3243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
02056NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC CurrentSince Aug 28, 2020 Accepting new patients
Knapp Street Psychiatry, PC CurrentSince Aug 29, 2020 Accepting new patients

Locations

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

3512 Quentin Rd
Ste 110
Brooklyn, NY 11234
Phone (718) 854-8370

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101

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.

NPI Registry JSON

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515542400000",
    "number": "1063662120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 VETERANS AVE",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148100810",
            "telephone_number": "607-664-4000",
            "fax_number": "607-664-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 VETERANS AVE",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148100810",
            "telephone_number": "607-664-4000",
            "fax_number": "607-664-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABLE",
        "first_name": "MELISSA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-25",
        "last_updated": "2018-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "02056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bath, NY

Sources for this page

Verify at the official NPI Registry.