Individual provider Active NPI

Scott Baum, PH.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1215951470
Registry record updated Dec 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
005538-1 Issued in NY
Practice address
275 W 96TH St Apt 26G
New York, NY 10025-6263
Phone
(212) 663-8607
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 005538-1 NY Primary

Addresses

Primary practice location

275 W 96TH St Apt 26G
New York, NY 10025-6263

Mailing address

160 W 73Rd St
Apt 1D
New York, NY 10023-3013
Phone (212) 665-3908

Other identifiers 1

IdentifierTypeStateIssuer
01675896MedicaidNY

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
I20110509000093 NY Practitioner - Clinical Psychologist 1850576844 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

160 W 73Rd St
Apt 1D
New York, NY 10023-3013
Phone (212) 665-3908

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
005538-1NYMDPsychologist
005538NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1215951470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 W 73RD ST",
            "address_2": "APT 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100233013",
            "telephone_number": "212-665-3908",
            "fax_number": "212-222-8972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W 96TH ST APT 26G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256263",
            "telephone_number": "212-663-8607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUM",
        "first_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "005538-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01675896",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.