Active NPI
Peggilee Wupperman, PH.D.
- Clinical Psychologist
- New York, NY
National Provider Identifier
1215262084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 68 018269
- Practice address
- 136 E 57TH St
New York, NY 10022-2707 - Phone
- (212) 237-8792
- NPI assigned
- Oct 12, 2009
- Last updated
- Dec 28, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 03-845068 | CT | |
| Clinical Psychologist | 103TC0700X | 68 018269 | NY | Primary |
Addresses
Primary practice location
136 E 57TH St
New York, NY 10022-2707
Mailing address
524 W 59TH St
Psychology, 10.63.20
New York, NY 10019-1007
Phone (212) 237-8792
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2013 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03-845068 | CT | MD | Psychologist |
| 68 018269 | NY | MD | Clinical Psychologist |
| 018269 | NY | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Robert L Leahy Psychologist PC Dba American Institute for Cognitiv | Clinical | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba American Institute for Cognitive Therapy
- Cognitive & Behavioral Psychologist
- New York, NY
- NPI 1134324106
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482883200000",
"number": "1215262084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "524 W 59TH ST",
"address_2": "PSYCHOLOGY, 10.63.20",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100191007",
"telephone_number": "212-237-8792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 E 57TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100222707",
"telephone_number": "212-237-8792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WUPPERMAN",
"first_name": "PEGGILEE",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-12",
"last_updated": "2016-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CT",
"license": "03-845068",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "68 018269",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Dec 28, 2016; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.