Active NPI
Ellen Soisson, PSY.D.
- Clinical Psychologist
- Albuquerque, NM
National Provider Identifier
1144844747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 491
- Practice address
- 11005 Spain Rd NE Ste 8
Albuquerque, NM 87111-1871 - Phone
- (505) 250-2312
- NPI assigned
- May 31, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 491 | NM | Primary |
Addresses
Primary practice location
11005 Spain Rd NE Ste 8
Albuquerque, NM 87111-1871
Mailing address
5716 Elderberry CT NE
Albuquerque, NM 87111-6224
Phone (505) 250-2312
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201215003274 | NM | Practitioner - Clinical Psychologist | 3577975531 | Practice locations: Albuquerque, NM |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
11005 Spain Rd NE
Albuquerque, NM 87111-1899
Phone (505) 250-2312
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 491 | NM | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590883200000",
"number": "1144844747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5716 ELDERBERRY CT NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871116224",
"telephone_number": "505-250-2312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11005 SPAIN RD NE STE 8",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871111871",
"telephone_number": "505-250-2312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOISSON",
"first_name": "ELLEN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-31",
"last_updated": "2020-05-31",
"certification_date": "2020-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NM",
"license": "491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.