Individual provider Active NPI

Christina Pansarasa, PH.D.

  • Clinical Psychologist
  • Mahopac, NY
National Provider Identifier
1144386798
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
013034-1 Issued in NY
Practice address
880 S Lake Blvd
Mahopac, NY 10541-4771
Phone
(914) 962-8772
Fax
(914) 243-7916
NPI assigned
Dec 28, 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
Clinical Psychologist 103TC0700X 013034-1 NY Primary

Addresses

Primary practice location

880 S Lake Blvd
Mahopac, NY 10541-4771

Mailing address

984 Hanover St
Yorktown Heights, NY 10598-5913
Phone (914) 962-8772

Other identifiers 4

IdentifierTypeStateIssuer
142239OtherNYVALUEOPTIONS, INC.
6888317002OtherNYGHI
196607OtherNYMHN
P2144259OtherNYOXFORD BEHAVIORAL HEALTH

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
013034-1NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144386798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "984 HANOVER ST",
            "city": "YORKTOWN HEIGHTS",
            "state": "NY",
            "postal_code": "105985913",
            "telephone_number": "914-962-8772",
            "fax_number": "914-243-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 S LAKE BLVD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105414771",
            "telephone_number": "914-962-8772",
            "fax_number": "914-243-7916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANSARASA",
        "first_name": "CHRISTINA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "013034-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS, INC.",
            "identifier": "142239",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6888317002",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "196607",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD BEHAVIORAL HEALTH",
            "identifier": "P2144259",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mahopac, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.