Individual provider Active NPI

Jon McCormick, PH.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1235250531
Registry record updated Dec 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
008249 Issued in NY
Practice address
88 University PL FL 8
New York, NY 10003-4513
Phone
(212) 929-5333
Fax
(212) 929-5333
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 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 008249 NY Primary

Addresses

Primary practice location

88 University PL FL 8
New York, NY 10003-4513

Mailing address

88 University PL FL 8
New York, NY 10003-4513
Phone (212) 929-5333

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
I20120105000079 NY Practitioner - Clinical Psychologist 9234305731 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

303 5TH Ave
RM 502
New York, NY 10016-6644
Phone (212) 929-5333

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008249NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Anne Chapman Kane PHD PC Psychologist 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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293408000000",
    "number": "1235250531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 UNIVERSITY PL FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034513",
            "telephone_number": "212-929-5333",
            "fax_number": "212-929-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 UNIVERSITY PL FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034513",
            "telephone_number": "212-929-5333",
            "fax_number": "212-929-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "JON",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2010-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "008249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.