Individual provider Active NPI

H. Michael Kushner, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1083903611
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
018780 Issued in NY
Practice address
90 Broad St Ste 211
New York, NY 10004-2205
Phone
(914) 400-4875
NPI assigned
Apr 5, 2011
Last updated
Apr 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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 018780 NY Primary

Addresses

Primary practice location

90 Broad St Ste 211
New York, NY 10004-2205

Mailing address

PO Box 20620
Staten Island, NY 10302-0620
Phone (914) 400-4875

Other names 1

  • Dr. Michael Kushner Professional name

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
I20240710004736 NY Practitioner - Clinical Psychologist 3072058353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

90 Broad St
Suite 211
New York, NY 10004-2205
Phone (914) 400-4875

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
018780NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
H Michael Kushner PHD Psychologist PLLC Clinical CurrentSince Jun 1, 2024 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1083903611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20620",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103020620",
            "telephone_number": "914-400-4875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BROAD ST STE 211",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042205",
            "telephone_number": "914-400-4875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSHNER",
        "first_name": "H.",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-05",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "018780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "KUSHNER",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.