Individual provider Active NPI

Janet Rose Mayes, PH.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1104980630
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
006036-1 Issued in NY
Practice address
138 W 25TH St
Suite 801
New York, NY 10001-7405
Phone
(212) 741-1080
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 006036-1 NY Primary

Addresses

Primary practice location

138 W 25TH St
Suite 801
New York, NY 10001-7405

Mailing address

138 W 25TH St
Suite 801
New York, NY 10001-7405
Phone (212) 741-1080

Other identifiers 5

IdentifierTypeStateIssuer
006036- NO1OtherNYH.I.P.
01293461MedicaidNY
1057740OtherNYBEACON
144437OtherNYVALUE OPTIONS
P1241718OtherNYOXFORD

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
I20040423000170 NY Practitioner - Clinical Psychologist 5698761765 Practice locations: New York, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
006036-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Planetarium Consulting & Psychotherapy Services Psychologist Past 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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104980630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 W 25TH ST",
            "address_2": "SUITE 801",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100017405",
            "telephone_number": "212-741-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 W 25TH ST",
            "address_2": "SUITE 801",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100017405",
            "telephone_number": "212-741-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYES",
        "first_name": "JANET",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "006036-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "H.I.P.",
            "identifier": "006036- NO1",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01293461",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON",
            "identifier": "1057740",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "144437",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1241718",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.