Carly Baetz, JD, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

021885 Issued in NY

Practice address

10 Nathan D Perlman PL
New York, NY 10003-3851

Phone

(917) 409-8989

NPI assigned

Oct 25, 2016

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

Other names 1

• Carly Baetz-Stangel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Juris Doctor, Doctor of Philosophy

State licenses

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1104378256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "443 17TH ST",
            "address_2": "APT 2L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112156233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 NATHAN D PERLMAN PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033851",
            "telephone_number": "917-409-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAETZ",
        "first_name": "CARLY",
        "credential": "JD, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-25",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "BAETZ-STANGEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ronald Darren Baer, D.M.D.
• Sydney Elizabeth Baer
• Yuliya Bulba Baer, PSYD
• Rebecca Baergen, M.D.
• Alanne Baerson, PH.D.
• Baewo Corp
• Jeisson Baez Abreu
• Maria Dilenia Baez Frias, RN
• Virginia Maria Baez Socorro, M.D.
• Yokasty Baez-Jimenez, REGISTERED NURSE

• Clinical Psychologist in New York, NY
• Providers in New York, 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 Oct 25, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.