Individual provider Active NPI

Ruth Hayes Landstrom, PH.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1184994014
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
014098-1 Issued in NY
Practice address
344 W 72ND St
Suite 1E
New York, NY 10023-2625
Phone
(212) 721-0499
Fax
(212) 721-0499
NPI assigned
Jan 10, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 014098-1 NY Primary

Addresses

Primary practice location

344 W 72ND St
Suite 1E
New York, NY 10023-2625

Mailing address

344 W 72ND St
Suite 1E
New York, NY 10023-2625
Phone (212) 721-0499

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
I20120117000489 NY Practitioner - Clinical Psychologist 0244407112 Practice locations: Warwick, NY; Monroe, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

28 Railroad Ave
Warwick, NY 10990-1639
Phone (845) 986-7686

28 Railroad Ave
Suite 4C
Warwick, NY 10990-1640

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014098-1NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sally James Rudnick, LCSW, PLLC PastSince Jan 5, 2021 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": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326153600000",
    "number": "1184994014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 W 72ND ST",
            "address_2": "SUITE 1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100232625",
            "telephone_number": "212-721-0499",
            "fax_number": "212-721-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 W 72ND ST",
            "address_2": "SUITE 1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100232625",
            "telephone_number": "212-721-0499",
            "fax_number": "212-721-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDSTROM",
        "first_name": "RUTH",
        "middle_name": "HAYES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "014098-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.