Richard Emerson Wall, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

009449 Issued in NY

Practice address

124 Merrick Ave Ste 1
Merrick, NY 11566-3434

Phone

(516) 318-2913

Fax

(516) 594-0929

NPI assigned

Mar 13, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1174159826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 STRATHMORE LN",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115701848",
            "telephone_number": "516-318-2913",
            "fax_number": "516-594-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MERRICK AVE STE 1",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115663434",
            "telephone_number": "516-318-2913",
            "fax_number": "516-594-0929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 Court St Ste 1214",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112421112",
            "country_code": "US",
            "telephone_number": "516-318-2913",
            "fax_number": "516-594-0929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALL",
        "first_name": "RICHARD",
        "middle_name": "EMERSON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-13",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "009449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Waldbaum Inc
• Amy NG Waldman, NP
• Brenda Waldner
• Elisabeth Chandlin Walker
• Richard Edward Walker, RPH
• Danny C Wang, MD, MPH
• Lydia Warner, PH.D
• Wendy Wasser, MA-SLP
• Anne Jennifer Waterman Carrington, MS
• Sheryl Joy Waters, SLP

• Clinical Psychologist in Merrick, NY
• Providers in Merrick, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.

Verify at the official NPI Registry.