Active NPI
Kristen Nicole Risola, PHD
- Clinical Psychologist
- Glen Oaks, NY
National Provider Identifier
1245616150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 021275
- Practice address
- 7559 263Rd St
Ambulatory Care Pavilion Door 2
Glen Oaks, NY 11004-1150 - Phone
- (718) 470-8060
- Fax
- (718) 470-1905
- NPI assigned
- Aug 3, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 021275 | NY | Primary |
Addresses
Primary practice location
7559 263Rd St
Ambulatory Care Pavilion Door 2
Glen Oaks, NY 11004-1150
Mailing address
7559 263Rd St
Ambulatory Care Pavilion Door 2
Glen Oaks, NY 11004-1150
Phone (718) 470-8060
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
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
75 -59
Glen Oaks, NY 11004-1150
Phone (718) 470-8100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
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.
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- Great Neck, NY
- NPI 1053688572
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439942400000",
"number": "1245616150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7559 263RD ST",
"address_2": "AMBULATORY CARE PAVILION DOOR 2",
"city": "GLEN OAKS",
"state": "NY",
"postal_code": "110041150",
"telephone_number": "718-470-8060",
"fax_number": "718-470-1905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7559 263RD ST",
"address_2": "AMBULATORY CARE PAVILION DOOR 2",
"city": "GLEN OAKS",
"state": "NY",
"postal_code": "110041150",
"telephone_number": "718-470-8060",
"fax_number": "718-470-1905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RISOLA",
"first_name": "KRISTEN",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-03",
"last_updated": "2015-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "021275",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Oaks, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.