Individual provider Active NPI

Mitchell Slutzky, PHD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1174551097
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
8055 Issued in NY
Practice address
225 E 74TH St Apt 4E
New York, NY 10021-3356
Phone
(212) 877-0914
Fax
(347) 338-2050
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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 8055 NY Primary

Addresses

Primary practice location

225 E 74TH St Apt 4E
New York, NY 10021-3356

Mailing address

225 E 74TH St Apt 4E
New York, NY 10021-3356
Phone (212) 877-0914

Other identifiers 1

IdentifierTypeStateIssuer
00984363MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040729000782 NY Practitioner - Clinical Psychologist 9133199813 Practice locations: New York, NY
I20241105000649 GA Practitioner - Clinical Psychologist 9133199813 Practice locations: Athens, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

673 Cobb St
Athens, GA 30606-2901
Phone (212) 877-0914

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
8055NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Barry L. Feinberg MD PC PastSince Nov 1, 2006 Accepting new patients
Geriatric Psychological Services PC Past Accepting new patients

Organizations & group practices 2

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1174551097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E 74TH ST APT 4E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213356",
            "telephone_number": "212-877-0914",
            "fax_number": "347-338-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E 74TH ST APT 4E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213356",
            "telephone_number": "212-877-0914",
            "fax_number": "347-338-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLUTZKY",
        "first_name": "MITCHELL",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "8055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00984363",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.