Ellen Keller, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

013125 Issued in NY

Practice address

81 Lincoln Ave
Deer Park, NY 11729-7015

Phone

(631) 902-0505

NPI assigned

Sep 11, 2014

Last updated

Sep 11, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bandl Cognitive Behavioral Psychology PLLCGroup PAC ID 1153470828, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• B&L Cognitive Behavioral Psychology PLLC

  dba New York Cognitive Therapy and Wellness Center

  • Clinical Psychologist
  • Rockville Centre, NY
  • NPI 1891875225
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1083015879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 LINCOLN AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117297015",
            "telephone_number": "631-902-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 LINCOLN AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117297015",
            "telephone_number": "631-902-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "013125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan R Kantro, DMD
• Saransh Kapoor
• Catty Kapsoli
• Laneya Katzman
• Simranjit Kaur
• Georgia Kelly-Williams
• Thomas Donald Kempton, PH.D.
• Gerard Kennedy
• Kenneth a. Paticoff, DDS, PC
• Kevin a Henner,DMD,PC (Henner Dental Associates)

• Clinical Psychologist in Deer Park, NY
• Providers in Deer Park, 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 Sep 11, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.