Individual provider Active NPI

Paul Greene, PHD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1184664104
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
016452 Issued in NY
Practice address
315 Madison Ave RM 806
New York, NY 10017-5432
Phone
(646) 863-4225
Fax
(347) 694-8199
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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 016452 NY Primary

Addresses

Primary practice location

315 Madison Ave RM 806
New York, NY 10017-5432

Mailing address

315 Madison Ave RM 806
New York, NY 10017-5432
Phone (646) 863-4225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 21, 2021 through Mar 21, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016452NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Manhattan Cognitive-Behavioral Therapy/Psychology, PLLC Current Accepting new patients
Che Senior Psychological Services, PC Clinical PastSince Feb 2, 2020 Accepting new patients

Locations

276 5th Ave
Rm 905
New York, NY 10001
Phone (212) 571-4249

50 E 42nd St
Rm 806
New York, NY 10017
Phone (212) 850-1100

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1184664104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MADISON AVE RM 806",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175432",
            "telephone_number": "646-863-4225",
            "fax_number": "347-694-8199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 MADISON AVE RM 806",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175432",
            "telephone_number": "646-863-4225",
            "fax_number": "347-694-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.