Individual provider Active NPI

Timothy Michael Enright, PH.D.

  • Clinical Psychologist
  • Rochester, NY
National Provider Identifier
1194802595
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
014597-1 Issued in NY
Practice address
247 Park Ave
Rochester, NY 14607-2723
Phone
(585) 242-0256
Fax
(585) 271-0883
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

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 Psychologist 103TC0700X 014597-1 NY Primary

Addresses

Primary practice location

247 Park Ave
Rochester, NY 14607-2723

Mailing address

247 Park Ave
Rochester, NY 14607-2723
Phone (585) 242-0256

Other identifiers 2

IdentifierTypeStateIssuer
7302466OtherNYAETNA
115159FCOtherNYPREFERRED CARE (MVP) ROCH

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
I20050831000586 NY Practitioner - Clinical Psychologist 6406888353 Practice locations: Rochester, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
George Washington University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

247 Park Ave
Rochester, NY 14607-2723
Phone (585) 242-0256

247 Park Ave
Rochester, NY 14607-2794

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014597-1NYMDClinical Psychologist
014597NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194802595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 PARK AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146072723",
            "telephone_number": "585-242-0256",
            "fax_number": "585-271-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 PARK AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146072723",
            "telephone_number": "585-242-0256",
            "fax_number": "585-271-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENRIGHT",
        "first_name": "TIMOTHY",
        "middle_name": "MICHAEL",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "014597-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7302466",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE (MVP) ROCH",
            "identifier": "115159FC",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.