Active NPI
Andrea Lynn Mortati, PSY.D.
- Psychologist
- Chappaqua, NY
National Provider Identifier
1164675922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 013617-1
- Practice address
- 12 Pond Hill Rd
Chappaqua, NY 10514-2531 - Phone
- (914) 299-1276
- NPI assigned
- Oct 24, 2008
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 013617-1 | NY | Primary |
Addresses
Primary practice location
12 Pond Hill Rd
Chappaqua, NY 10514-2531
Mailing address
12 Pond Hill Rd
Chappaqua, NY 10514-2531
Phone (914) 299-1276
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013617-1 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224806400000",
"number": "1164675922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 POND HILL RD",
"city": "CHAPPAQUA",
"state": "NY",
"postal_code": "105142531",
"telephone_number": "914-299-1276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 POND HILL RD",
"city": "CHAPPAQUA",
"state": "NY",
"postal_code": "105142531",
"telephone_number": "914-299-1276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORTATI",
"first_name": "ANDREA",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-24",
"last_updated": "2008-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "013617-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chappaqua, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.