Active NPI
Kurt Stephen Halliday, PHD
- Psychologist
- Canton, NY
National Provider Identifier
1194781146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 017077
- Practice address
- 5862 US Highway 11 the Tallman House
Psychological Associates
Canton, NY 13617 - Phone
- (315) 262-5355
- NPI assigned
- Apr 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 1788 | CO | |
| Clinical Psychologist | 103TC0700X | 017077 | NY | |
| Psychologist | 103T00000X | 017077 | NY | Primary |
Addresses
Primary practice location
5862 US Highway 11 the Tallman House
Psychological Associates
Canton, NY 13617
Mailing address
58 May Road
Potsdam, NY 13676
Phone (315) 262-5355
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 95926534 | Medicaid | CO |
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
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 98.56 of 100
- Quality
- 87.76
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1788 | CO | MD | Acupuncturist |
| 017077 | NY | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Canton-Potsdam Hospital | Current | Accepting new patients | |
| Canton-Potsdam Hospital | Current | Accepting new patients |
Locations
12 Elm St
Potsdam, NY 13676
Phone (315) 261-5420
50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034
201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102
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.
-
- General Acute Care Hospital
- Potsdam, NY
- NPI 1568548782
-
- Medicare Defined Swing Bed Hospital Unit
- Potsdam, NY
- NPI 1114104445
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364947200000",
"number": "1194781146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "58 MAY ROAD",
"city": "POTSDAM",
"state": "NY",
"postal_code": "13676",
"telephone_number": "315-262-5355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5862 US HIGHWAY 11 THE TALLMAN HOUSE",
"address_2": "PSYCHOLOGICAL ASSOCIATES",
"city": "CANTON",
"state": "NY",
"postal_code": "13617",
"telephone_number": "315-262-5355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLIDAY",
"first_name": "KURT",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-26",
"last_updated": "2013-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "CO",
"license": "1788",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "017077",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "017077",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "95926534",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Canton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.