Individual provider Active NPI

Scott David Hirose, PSY.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1073833166
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
018562-1 Issued in NY
Practice address
525 W End Ave
Suite 1D
New York, NY 10024-3267
Phone
(646) 236-2248
NPI assigned
Jun 11, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 018562-1 NY Primary

Addresses

Primary practice location

525 W End Ave
Suite 1D
New York, NY 10024-3267

Mailing address

525 W End Ave
Suite 1D
New York, NY 10024-3267
Phone (646) 236-2248

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
I20140221000761 NY Order and Referring Only - Clinical Psychologist 4284864166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
018562-1NYMDPhysical Rehabilitation Occupational Therapist

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

NPI Registry JSON

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1073833166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 W END AVE",
            "address_2": "SUITE 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100243267",
            "telephone_number": "646-236-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W END AVE",
            "address_2": "SUITE 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100243267",
            "telephone_number": "646-236-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIROSE",
        "first_name": "SCOTT",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-11",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "018562-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.