Individual provider Active NPI

Lisa Shapir, PSYD

  • Psychologist
  • East Northport, NY
National Provider Identifier
1083082341
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
013193 Issued in NY
Practice address
554 Larkfield Rd Ste 204
East Northport, NY 11731-4205
Phone
(631) 438-1069
NPI assigned
Sep 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 013193 NY
Clinical Psychologist 103TC0700X 013193 NY
Counseling Psychologist 103TC1900X 013193 NY
Clinical Child & Adolescent Psychologist 103TC2200X 013193 NY
Family Psychologist 103TF0000X 013193 NY
Group Psychotherapy Psychologist 103TP2701X 013193 NY
School Psychologist 103TS0200X 013193 NY
Psychologist 103T00000X 013193 NY Primary

Addresses

Primary practice location

554 Larkfield Rd Ste 204
East Northport, NY 11731-4205

Mailing address

554 Larkfield Rd Ste 204
E Northport, NY 11731-4205

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
I20180515002014 NY Practitioner - Clinical Psychologist 8426312638 Practice locations: East Northport, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

554 Larkfield Rd
Suite 204
East Northport, NY 11731-4205
Phone (631) 437-0677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013193NYMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Commack Psychology PC Clinical PastSince Dec 18, 2022 Accepting new patients

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": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1083082341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 LARKFIELD RD STE 204",
            "city": "E NORTHPORT",
            "state": "NY",
            "postal_code": "117314205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 LARKFIELD RD STE 204",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117314205",
            "telephone_number": "631-438-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIR",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NY",
            "license": "013193",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "013193",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NY",
            "license": "013193",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "013193",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "NY",
            "license": "013193",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NY",
            "license": "013193",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": "013193",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "013193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Northport, NY

Sources for this page

Verify at the official NPI Registry.