Active NPI
Alan M Smirnoff, PSY.D.
- Clinical Psychologist
- Cheshire, CT
National Provider Identifier
1154530269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 001414
- Practice address
- 408 Highland Ave
Suite A2
Cheshire, CT 06410-2525 - Phone
- (203) 271-1900
- Fax
- (203) 699-0907
- NPI assigned
- May 22, 2007
- Sex
- Male
- 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 | 001414 | CT | Primary |
Addresses
Primary practice location
408 Highland Ave
Suite A2
Cheshire, CT 06410-2525
Mailing address
408 Highland Ave
Suite A2
Cheshire, CT 06410-2525
Phone (203) 271-1900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- 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 |
|---|---|---|---|---|
| I20120620000662 | CT | Practitioner - Clinical Psychologist | 9739355629 | Practice locations: Cheshire, CT |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
408 Highland Ave
Suite A2
Cheshire, CT 06410-2525
Phone (203) 271-1900
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001414 | CT | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322524800000",
"number": "1154530269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "408 HIGHLAND AVE",
"address_2": "SUITE A2",
"city": "CHESHIRE",
"state": "CT",
"postal_code": "064102525",
"telephone_number": "203-271-1900",
"fax_number": "203-699-0907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "408 HIGHLAND AVE",
"address_2": "SUITE A2",
"city": "CHESHIRE",
"state": "CT",
"postal_code": "064102525",
"telephone_number": "203-271-1900",
"fax_number": "203-699-0907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMIRNOFF",
"first_name": "ALAN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2011-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "001414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cheshire, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; 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.