Individual provider Active NPI

Mark Balaban

  • Psychologist
  • New Paltz, NY
National Provider Identifier
1184640427
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
016581 Issued in NY
Practice address
29 S Chestnut St Ste 105
New Paltz, NY 12561-1949
Phone
(845) 616-7898
NPI assigned
Jul 13, 2006
Last updated
Apr 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 016581 NY Primary

Addresses

Primary practice location

29 S Chestnut St Ste 105
New Paltz, NY 12561-1949

Mailing address

20 Holland LN
New Paltz, NY 12561-2221
Phone (845) 616-7898

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070730000683 NY Practitioner - Clinical Psychologist 4587765888 Practice locations: New Paltz, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

29 S Chestnut St
Suite 105
New Paltz, NY 12561-1949
Phone (845) 616-7898

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016581NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Integral Chiropractic, P.C. PastSince Nov 16, 2013 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1184640427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HOLLAND LN",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125612221",
            "telephone_number": "845-616-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 S CHESTNUT ST STE 105",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611949",
            "telephone_number": "845-616-7898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALABAN",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "016581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Paltz, NY

Sources for this page

Verify at the official NPI Registry.