Individual provider Active NPI

William Dana Lubart, PH.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1295856698
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
012740 Issued in NY
Practice address
450 W 24TH St
Suite 1a
New York, NY 10011-1351
Phone
(212) 627-2134
NPI assigned
Apr 3, 2007
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
Psychologist 103T00000X 012740 NY Primary

Addresses

Primary practice location

450 W 24TH St
Suite 1a
New York, NY 10011-1351

Mailing address

520 W 23Rd St
Apt. 5E
New York, NY 10011-1132
Phone (212) 627-2134

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
I20060418000484 NY Practitioner - Clinical Psychologist 1658380720 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

450 W 24TH St
Suite 1a
New York, NY 10011-1357
Phone (212) 627-2134

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012740NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295856698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 W 23RD ST",
            "address_2": "APT. 5E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100111132",
            "telephone_number": "212-627-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 W 24TH ST",
            "address_2": "SUITE 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100111351",
            "telephone_number": "212-627-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBART",
        "first_name": "WILLIAM",
        "middle_name": "DANA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "012740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.