Active NPI
Edward S. Ragsdale, PH.,D.
- Clinical Psychologist
- New York, NY
National Provider Identifier
1245302140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 9211-1
- Practice address
- 16 Madison SQ W FL 12
New York, NY 10010-1629 - Phone
- (212) 989-5803
- Fax
- (212) 243-4511
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- 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 | 9211-1 | NY | Primary |
Addresses
Primary practice location
16 Madison SQ W FL 12
New York, NY 10010-1629
Mailing address
51 5TH Ave
Apt. 16D
New York, NY 10003-4320
Phone (212) 255-1488
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 |
|---|---|---|---|---|
| I20050211000590 | NY | Practitioner - Clinical Psychologist | 5698727253 | Practice locations: New York, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
16 Madison SQ W
FL 12
New York, NY 10010-1629
Phone (212) 989-5803
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9211-1 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645056000000",
"number": "1245302140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 5TH AVE",
"address_2": "APT. 16D",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100034320",
"telephone_number": "212-255-1488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 MADISON SQ W FL 12",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100101629",
"telephone_number": "212-989-5803",
"fax_number": "212-243-4511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAGSDALE",
"first_name": "EDWARD",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "PH.,D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2022-02-17",
"certification_date": "2022-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "9211-1",
"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 Feb 17, 2022; 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.