Individual provider Active NPI

Amberlee Lynn Stuber-Novak, PSY.D.

  • Clinical Psychologist
  • Cooper City, FL
National Provider Identifier
1225620495
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY10705 Issued in FL
Practice address
4998 SW 88TH Ter
Cooper City, FL 33328-3615
Phone
(954) 593-9545
NPI assigned
Feb 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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 PY10705 FL Primary

Addresses

Primary practice location

4998 SW 88TH Ter
Cooper City, FL 33328-3615

Mailing address

4998 SW 88TH Ter
Cooper City, FL 33328-3615
Phone (954) 593-9545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, WI, IA, WA4 enrollments
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20250519003278 DC Practitioner - Clinical Psychologist 8921441262 Reassigns benefits to 1 organization
I20250521001471 WI Practitioner - Clinical Psychologist 8921441262 Reassigns benefits to 1 organization
I20250522001889 IA Practitioner - Clinical Psychologist 8921441262 Reassigns benefits to 1 organization
I20250527000799 WA Practitioner - Clinical Psychologist 8921441262 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY10705FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA CurrentSince Jan 2, 2024 Accepting new patients
Teladoc Health Medical Group, P.a. Current Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

699 Walnut St
Ste 4
Des Moines, IA 50309
Phone (515) 278-9920

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

4321 W College Ave
Ste 200
Appleton, WI 54914
Phone (920) 519-2920

Interoperability endpoints

  • Direct secure messaging: amberleestubernovak@tdh.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1225620495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4998 SW 88TH TER",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333283615",
            "telephone_number": "954-593-9545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4998 SW 88TH TER",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333283615",
            "telephone_number": "954-593-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUBER-NOVAK",
        "first_name": "AMBERLEE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-09",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY10705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooper City, FL

Sources for this page

Verify at the official NPI Registry.