Individual provider Active NPI

Michelle Duchnowski, PSY.D.

  • Psychologist
  • Jericho, NY
National Provider Identifier
1083778526
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
022082 Issued in NY
Practice address
500 N Broadway
Jericho, NY 11753-2127
Phone
(516) 341-2184
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychologist 103T00000X 022082 NY Primary

Addresses

Primary practice location

500 N Broadway
Jericho, NY 11753-2127

Mailing address

657 Hilda St
East Meadow, NY 11554-5464

Other practice location 1

570 Elmont Rd
Elmont, NY 11003-3535
Phone (516) 437-6050

Other identifiers 1

IdentifierTypeStateIssuer
022082OtherNYNEW YORK STATE DEPARTMENT OF EDUCATION

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

State licenses

LicenseStateTypeSpecialty
022082NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family and Children'S Association - Linkage Past Accepting new patients
B&L Cognitive Behavioral Psychology PLLC Past Accepting new patients

Organizations & group practices 2

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1083778526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 HILDA ST",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115545464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N BROADWAY",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117532127",
            "telephone_number": "516-341-2184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "570 Elmont Rd",
            "address_purpose": "LOCATION",
            "city": "Elmont",
            "state": "NY",
            "postal_code": "110033535",
            "country_code": "US",
            "telephone_number": "516-437-6050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUCHNOWSKI",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "022082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE DEPARTMENT OF EDUCATION",
            "identifier": "022082",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jericho, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.