Individual provider Active NPI

Jacqueline Sirena Schachter, PH.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1255515540
Registry record updated Dec 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
8047 Issued in NY
Practice address
24 E 12TH St RM 704
New York, NY 10003-4538
Phone
(212) 366-5825
NPI assigned
Dec 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 8047 NY Primary

Addresses

Primary practice location

24 E 12TH St RM 704
New York, NY 10003-4538

Mailing address

24 E 12TH St RM 704
New York, NY 10003-4538
Phone (212) 366-5825

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110419000913 NY Practitioner - Clinical Psychologist 9931384880 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
State University of New York at Stony Brook, School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

303 5TH Ave
RM 2009
New York, NY 10016-6625
Phone (212) 366-5825

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
8047NYMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198195200000",
    "number": "1255515540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 E 12TH ST RM 704",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034538",
            "telephone_number": "212-366-5825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 E 12TH ST RM 704",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034538",
            "telephone_number": "212-366-5825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHACHTER",
        "first_name": "JACQUELINE",
        "middle_name": "SIRENA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-21",
        "last_updated": "2007-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "8047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.