Individual provider Active NPI

Kristina Wong Thies, PSY.D.

  • Psychologist
  • Forest Hills, NY
National Provider Identifier
1063896850
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
11835 Queens Blvd
Forest Hills, NY 11375-7200
Phone
(917) 426-1170
NPI assigned
Jul 12, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

11835 Queens Blvd
Forest Hills, NY 11375-7200

Mailing address

11050 71St Rd Ste 1M
Forest Hills, NY 11375-4972
Phone (917) 426-1170

Other practice location 1

142 Joralemon St
3E
Brooklyn, NY 11201-4747
Phone (718) 935-0400

Other practice location 2

11050 71st Rd Ste 1M
Forest Hills, NY 11375-4972
Phone (917) 426-1170

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wong Thies Psychology, PLLC CurrentSince Aug 9, 2020 Accepting new patients

Locations

11050 71st Rd
Ste 1M
Forest Hills, NY 11375
Phone (718) 263-9161

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1436659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1063896850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 71ST RD STE 1M",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754972",
            "telephone_number": "917-426-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757200",
            "telephone_number": "917-426-1170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "142 Joralemon St",
            "address_2": "3E",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112014747",
            "country_code": "US",
            "telephone_number": "718-935-0400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11050 71st Rd Ste 1M",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113754972",
            "country_code": "US",
            "telephone_number": "917-426-1170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG THIES",
        "first_name": "KRISTINA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-12",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.