Individual provider Active NPI

Mitchell M. Frank, PSY.D

  • Clinical Psychologist
  • Forest Hills, NY
National Provider Identifier
1275643454
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
012366 Issued in NY
Practice address
11021 73Rd Rd Apt 1J
Forest Hills, NY 11375-6369
Phone
(646) 331-0322
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 012366 NY Primary

Addresses

Primary practice location

11021 73Rd Rd Apt 1J
Forest Hills, NY 11375-6369

Mailing address

10915 Queens Blvd Apt 1K
Forest Hills, NY 11375-5483
Phone (718) 544-5237

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
I20260323001451 NY Practitioner - Clinical Psychologist 9335623875 Practice locations: Forest Hills, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

41 Watchung PLZ
Suite 519
Montclair, NJ 07042-4117

6692 Selfridge St
Apt 4K
Forest Hills, NY 11375-4186
Phone (646) 331-0322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Housestaff Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275643454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10915 QUEENS BLVD APT 1K",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755483",
            "telephone_number": "718-544-5237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11021 73RD RD APT 1J",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756369",
            "telephone_number": "646-331-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANK",
        "first_name": "MITCHELL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "012366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.