Active NPI
Jeffre Phillip Cheuvront Jr., PSY.D.
- Psychologist
- New York, NY
National Provider Identifier
1083648554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 013557
- Practice address
- 200 W 20TH St
Suite 104
New York, NY 10011-3558 - Phone
- (212) 352-8599
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 013557 | NY | Primary |
Addresses
Primary practice location
200 W 20TH St
Suite 104
New York, NY 10011-3558
Mailing address
63 E 9TH St
Apt 11F
New York, NY 10003-6302
Phone (212) 352-8599
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01863670 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2019 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013557 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307577600000",
"number": "1083648554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63 E 9TH ST",
"address_2": "APT 11F",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100036302",
"telephone_number": "212-352-8599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W 20TH ST",
"address_2": "SUITE 104",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100113558",
"telephone_number": "212-352-8599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEUVRONT",
"first_name": "JEFFRE",
"middle_name": "PHILLIP",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2011-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "013557",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01863670",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.