Individual provider Active NPI

Deborah King Kundert, PHD

  • Clinical Neuropsychologist
  • Albany, NY
National Provider Identifier
1174653281
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
010764 Issued in NY
Practice address
1740 Western Ave
Suite 100
Albany, NY 12203-4414
Phone
(518) 464-5060
Fax
(518) 464-5023
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 010764 NY Primary

Addresses

Primary practice location

1740 Western Ave
Suite 100
Albany, NY 12203-4414

Mailing address

33 Rockrose Drive
East Greenbush, NY 12061-1673
Phone (518) 436-3674

Other identifiers 3

IdentifierTypeStateIssuer
V889AOtherEMPIRE BCBS
000490284003OtherBSNENY
10016143OtherCDPHP

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
010764NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
McCaffrey Psychological PC Clinical Neuropsychologist PastSince Jun 1, 2006 Accepting new patients

Organizations & group practices 1

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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174653281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 ROCKROSE DRIVE",
            "city": "EAST GREENBUSH",
            "state": "NY",
            "postal_code": "120611673",
            "telephone_number": "518-436-3674",
            "fax_number": "518-464-5023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 WESTERN AVE",
            "address_2": "SUITE 100",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122034414",
            "telephone_number": "518-464-5060",
            "fax_number": "518-464-5023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNDERT",
        "first_name": "DEBORAH",
        "middle_name": "KING",
        "name_prefix": "Ms.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "010764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS",
            "identifier": "V889A",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSNENY",
            "identifier": "000490284003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10016143",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.