Individual provider Active NPI

Ann F Wimpfheimer, PSYD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1114065562
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
014115-1 Issued in NY
Practice address
865 W End Ave
Suite 1 a
New York, NY 10025-8401
Phone
(212) 666-5311
NPI assigned
Feb 1, 2007
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
Clinical Psychologist 103TC0700X 014115-1 NY Primary

Addresses

Primary practice location

865 W End Ave
Suite 1 a
New York, NY 10025-8401

Mailing address

300 Riverside Dr
4E
New York, NY 10025-5279
Phone (212) 666-5311

Other identifiers 4

IdentifierTypeStateIssuer
7758801OtherAETNA
P1937348OtherOXFORD
7349715OtherNYGHI
11433876OtherCAQH

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
I20060110000904 NY Practitioner - Clinical Psychologist 6406879931 Practice locations: New York, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014115-1NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114065562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 RIVERSIDE DR",
            "address_2": "4E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100255279",
            "telephone_number": "212-666-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 W END AVE",
            "address_2": "SUITE 1 A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100258401",
            "telephone_number": "212-666-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIMPFHEIMER",
        "first_name": "ANN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "014115-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7758801",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1937348",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7349715",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11433876",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.