Individual provider Active NPI

Joan Wertheim, PHD

  • Psychologist
  • New York, NY
National Provider Identifier
1114956455
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
007675 Issued in NY
Practice address
600 3Rd Ave
#265
New York, NY 10016-1901
Phone
(212) 736-2177
NPI assigned
Jun 30, 2006
Last updated
Apr 3, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 007675 NY Primary

Addresses

Primary practice location

600 3Rd Ave
#265
New York, NY 10016-1901

Mailing address

15 W 43Rd St
#43
New York, NY 10036-7402
Phone (212) 736-2177

Other identifiers 1

IdentifierTypeStateIssuer
00934809MedicaidNY

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)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell and Santoro Psychologists, PC Psychologist Past Accepting new patients
Hospitalist Healthcare Services PLLC Past Accepting new patients
R.P.P., Inc. Past Accepting new patients
Spectrum Psychology Services, PLLC Past Accepting new patients

Organizations & group practices 4

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1114956455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 W 43RD ST",
            "address_2": "#43",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100367402",
            "telephone_number": "212-736-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 3RD AVE",
            "address_2": "#265",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100161901",
            "telephone_number": "212-736-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERTHEIM",
        "first_name": "JOAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "007675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00934809",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; 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.