Individual provider Active NPI

Mark Schachter, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Williamsville, NY
National Provider Identifier
1295844280
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
006424 Issued in NY
Practice address
388 Evans St
Williamsville, NY 14221-5626
Phone
(716) 633-0103
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 6424 NY
Clinical Child & Adolescent Psychologist 103TC2200X 006424 NY Primary

Addresses

Primary practice location

388 Evans St
Williamsville, NY 14221-5626

Mailing address

388 Evans St
Williamsville, NY 14221-5626
Phone (716) 633-0103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20260417001736 VA Practitioner - Clinical Psychologist 6901198258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jaclyn Mouras PSYD PLLCGroup PAC ID 2163807652, 2 clinicians

Practice addresses (Care Compare)

16 Ivy Ridge LN
Suite A14
Fishersville, VA 22939-2354
Phone (540) 221-1846

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6424NYMDClinical Neuropsychologist

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": "1757548800000",
    "number": "1295844280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 EVANS ST",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215626",
            "telephone_number": "716-633-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 EVANS ST",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215626",
            "telephone_number": "716-633-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHACHTER",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "6424",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "006424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.