Active NPI
Jantra Margarita Coll, PSY.D.
- Clinical Psychologist
- Brooklyn, NY
National Provider Identifier
1245698414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 021533
- Practice address
- 505 Graham Ave
Apt. 1R
Brooklyn, NY 11222-4934 - Phone
- (917) 270-7178
- NPI assigned
- Feb 3, 2016
- 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 | 021533 | NY | Primary |
Addresses
Primary practice location
505 Graham Ave
Apt. 1R
Brooklyn, NY 11222-4934
Mailing address
505 Graham Ave
Apt. 1R
Brooklyn, NY 11222-4934
Phone (917) 270-7178
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 |
|---|---|---|---|---|
| I20221115000263 | NY | Order and Referring Only - Clinical Psychologist | 5890163315 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021533 | NY | MD | Speech-Language Pathologist |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454457600000",
"number": "1245698414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 GRAHAM AVE",
"address_2": "APT. 1R",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112224934",
"telephone_number": "917-270-7178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 GRAHAM AVE",
"address_2": "APT. 1R",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112224934",
"telephone_number": "917-270-7178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLL",
"first_name": "JANTRA",
"middle_name": "MARGARITA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-03",
"last_updated": "2016-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "021533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.