Individual provider Active NPI

Kimberly Kassay, PSYD

  • Clinical Child & Adolescent Psychologist
  • Purchase, NY
National Provider Identifier
1245967074
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
020928 Issued in NY
Practice address
2975 Westchester Ave
Purchase, NY 10577-2518
Phone
(914) 358-9927
NPI assigned
Aug 2, 2022
Last updated
Aug 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 020928 NY Primary

Addresses

Primary practice location

2975 Westchester Ave
Purchase, NY 10577-2518

Mailing address

2975 Westchester Ave
Purchase, NY 10577-2518
Phone (914) 358-9927

Other identifiers 1

IdentifierTypeStateIssuer
020928OtherNYNYS LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
020928NYMDClinical Child & Adolescent Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1245967074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2975 WESTCHESTER AVE",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "105772518",
            "telephone_number": "914-358-9927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2975 WESTCHESTER AVE",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "105772518",
            "telephone_number": "914-358-9927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSAY",
        "first_name": "KIMBERLY",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-02",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "020928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "020928",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Purchase, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.