Individual provider Active NPI

Matthew E. Korner, PSY.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1295989317
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
017567 Issued in NY
Practice address
32 Union SQ E Ste 1100
New York, NY 10003-3209
Phone
(917) 916-9052
NPI assigned
Nov 17, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 017567 NY
Rehabilitation Psychologist 103TR0400X 017567 NY
Clinical Psychologist 103TC0700X 017567 NY Primary

Addresses

Primary practice location

32 Union SQ E Ste 1100
New York, NY 10003-3209

Mailing address

4 Dogwood Close
Briarcliff Manor, NY 10510-1905
Phone (917) 916-9052

Other practice location 1

444 Bedford Rd Ste 307
Pleasantville, NY 10570-3031
Phone (917) 916-9052

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
I20090317000635 NY Practitioner - Clinical Psychologist 5496812547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Matthew E Korner PSYD PCGroup PAC ID 4587890918, 4 clinicians

Practice addresses (Care Compare)

32 Union SQ E
Suite 1100
New York, NY 10003-3226
Phone (917) 916-9052

444 Bedford Rd
Suite 307
Pleasantville, NY 10570-3031
Phone (917) 916-9052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
017567NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew E Korner PSYD PC Clinical CurrentSince Sep 23, 2013 Accepting new patients

Locations

32 Union Sq E
Ste 1100
New York, NY 10003
Phone (212) 675-3205

444 Bedford Rd
#307
Pleasantville, NY 10570
Phone (917) 907-5225

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": "1226880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1295989317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 DOGWOOD CLOSE",
            "city": "BRIARCLIFF MANOR",
            "state": "NY",
            "postal_code": "105101905",
            "telephone_number": "917-916-9052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 UNION SQ E STE 1100",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033209",
            "telephone_number": "917-916-9052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "444 Bedford Rd Ste 307",
            "address_purpose": "LOCATION",
            "city": "Pleasantville",
            "state": "NY",
            "postal_code": "105703031",
            "country_code": "US",
            "telephone_number": "917-916-9052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORNER",
        "first_name": "MATTHEW",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-17",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "017567",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "NY",
            "license": "017567",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "017567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.