Individual provider Active NPI

Kimmy Ramotar, PSYD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1144703687
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
022867 Issued in NY
Practice address
733 3Rd Ave
New York, NY 10017-3204
Phone
(646) 496-5412
Fax
(855) 930-2883
NPI assigned
Sep 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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 022867 NY Primary

Addresses

Primary practice location

733 3Rd Ave
New York, NY 10017-3204

Mailing address

733 3Rd Ave FL 16
#1047
New York, NY 10017-3224
Phone (646) 450-3064

Other practice location 1

733 3rd Ave Fl 16
New York, NY 10017-3224
Phone (646) 496-5412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 4, 2022 through Nov 4, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
022867NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Real You Nutrition PLLC CurrentSince Aug 5, 2022 Accepting new patients

Locations

2175 Wantagh Ave
Wantagh, NY 11793
Phone (516) 344-5542

Interoperability endpoints

  • Direct secure messaging: kimmyramotar@nslijmedgr.allscriptsdirect.net

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": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1144703687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 3RD AVE FL 16",
            "address_2": "#1047",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100173224",
            "telephone_number": "646-450-3064",
            "fax_number": "855-930-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 3RD AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100173204",
            "telephone_number": "646-496-5412",
            "fax_number": "855-930-2883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "733 3rd Ave Fl 16",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100173224",
            "country_code": "US",
            "telephone_number": "646-496-5412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAMOTAR",
        "first_name": "KIMMY",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2023-04-11",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "022867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.