Individual provider Active NPI

Cynthia Heller

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1306980784
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
011091 Issued in NY
Practice address
165 E 89TH St
Suite I
New York, NY 10128-2315
Phone
(212) 860-0296
NPI assigned
Feb 17, 2007
Sex
Female
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 011091 NY Primary

Addresses

Primary practice location

165 E 89TH St
Suite I
New York, NY 10128-2315

Mailing address

2 Arbor Dr
New Rochelle, NY 10804-1101
Phone (914) 712-1565

Other identifiers 2

IdentifierTypeStateIssuer
P747719OtherNYOXFORD
01475209MedicaidNY

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
I20040510000320 NY Practitioner - Clinical Psychologist 6103815709 Practice locations: New Rochelle, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2 Arbor Dr
New Rochelle, NY 10804-1101
Phone (914) 712-1565

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011091NYMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306980784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 ARBOR DR",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108041101",
            "telephone_number": "914-712-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 E 89TH ST",
            "address_2": "SUITE I",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101282315",
            "telephone_number": "212-860-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLER",
        "first_name": "CYNTHIA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "011091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P747719",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01475209",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.