Individual provider Active NPI

Jie Zeng, PSY.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1205140357
Registry record updated Jul 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
018684 Issued in NY
Practice address
161 Madison Ave
Suite 2W
New York, NY 10016-5421
Phone
(212) 683-8905
Fax
(212) 683-8906
NPI assigned
Jul 31, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 018684 NY Primary

Addresses

Primary practice location

161 Madison Ave
Suite 2W
New York, NY 10016-5421

Mailing address

6214 Boelsen Cres
Rego Park, NY 11374-3932
Phone (917) 655-1162

Other names 1

  • Emily Zeng Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
018684NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Life Achievement, Inc. Past 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": "1280534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280534400000",
    "number": "1205140357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6214 BOELSEN CRES",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743932",
            "telephone_number": "917-655-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 MADISON AVE",
            "address_2": "SUITE 2W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165421",
            "telephone_number": "212-683-8905",
            "fax_number": "212-683-8906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZENG",
        "first_name": "JIE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-31",
        "last_updated": "2010-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "018684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "ZENG",
            "credential": "PSY.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.