Active NPI
Elaine H. Tulis, PH.D.
- Clinical Psychologist
- Chappaqua, NY
National Provider Identifier
1235207580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6469-1
- Practice address
- 21 Gray Rock LN
Chappaqua, NY 10514-2511 - Phone
- (914) 238-5359
- Fax
- (914) 238-5359
- NPI assigned
- Dec 2, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6469-1 | NY | Primary |
Addresses
Primary practice location
21 Gray Rock LN
Chappaqua, NY 10514-2511
Mailing address
21 Gray Rock LN
Chappaqua, NY 10514-2511
Phone (914) 238-5359
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0022639 | Other | NY | GHI |
| 00584414 | Medicaid | NY |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120126000020 | NY | Practitioner - Clinical Psychologist | 2961679345 | Practice locations: Chappaqua, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
21 Gray Rock Lane
Chappaqua, NY 10514-2511
Phone (914) 238-5359
21 Gray Rock LN
Chappaqua, NY 10514-2511
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006469 | NY | MD | Mental Health Counselor |
| 6469-1 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1235207580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 GRAY ROCK LN",
"city": "CHAPPAQUA",
"state": "NY",
"postal_code": "105142511",
"telephone_number": "914-238-5359",
"fax_number": "914-238-5359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 GRAY ROCK LN",
"city": "CHAPPAQUA",
"state": "NY",
"postal_code": "105142511",
"telephone_number": "914-238-5359",
"fax_number": "914-238-5359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TULIS",
"first_name": "ELAINE",
"middle_name": "H.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-02",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "6469-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "0022639",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00584414",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chappaqua, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.