Sandra Jane Eller, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

7743-1 Issued in NY

Practice address

200 White Spruce Blvd
Rochester, NY 14623-1605

Phone

(585) 427-0270

Fax

(585) 427-0270

NPI assigned

Jan 13, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1255482766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WHITE SPRUCE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146231605",
            "telephone_number": "585-427-0270",
            "fax_number": "585-427-0270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WHITE SPRUCE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146231605",
            "telephone_number": "585-427-0270",
            "fax_number": "585-427-0270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLER",
        "first_name": "SANDRA",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-13",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "7743-1",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "7743-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "73334000",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ellen Carrion
• Ellen Cullen OT, PLLC
• Stephanie Marchetta Ellens, PA
• Bridgette Ellenwood, LPN
• Eileen Marie Eller, M.S., CCC-SLP
• Charles Rober Ellermeyer, OD
• Emilie Ellicott, DO
• John Ellie Jr., D.P.M.
• Ronald Francis Ellingham Jr., RN
• Shuntay Ellington, LPN

• Clinical Child & Adolescent Psychologist in Rochester, NY
• Providers in Rochester, NY by specialty
• Clinical Child & Adolescent Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.

Verify at the official NPI Registry.