Individual provider Active NPI

Tedd R. Habberfield, PH.D.

  • Clinical Psychologist
  • Williamsville, NY
National Provider Identifier
1316928245
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
011033 Issued in NY
Practice address
37 S Cayuga Rd
Williamsville, NY 14221-6705
Phone
(716) 626-7492
Fax
(716) 626-4496
NPI assigned
Nov 8, 2005
Last updated
Sep 23, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X 011033 NY
Cognitive & Behavioral Psychologist 103TB0200X 011033 NY
Clinical Psychologist 103TC0700X 011033 NY Primary
Family Psychologist 103TF0000X 011033 NY

Addresses

Primary practice location

37 S Cayuga Rd
Williamsville, NY 14221-6705

Mailing address

37 S Cayuga Rd
Williamsville, NY 14221-6705
Phone (716) 626-7492

Other identifiers 3

IdentifierTypeStateIssuer
20207801OtherNYEXCELLUS HEALTH
6104050OtherNYINDEPENDENT HEALTH
000511263001OtherNYHEALTH NOW

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111215000106 NY Practitioner - Clinical Psychologist 9032384318 Practice locations: Williamsville, NY
I20190618002981 VT Practitioner - Clinical Psychologist 9032384318 Practice locations: Bennington, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

160 Benmont Ave
Suite 20
Bennington, VT 05201-1842
Phone 8024423520202

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011033NYMDFamily Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
SG Chiropractic Health Care, PC PastSince May 9, 2016 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1316928245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 S CAYUGA RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216705",
            "telephone_number": "716-626-7492",
            "fax_number": "716-626-4496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 S CAYUGA RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216705",
            "telephone_number": "716-626-7492",
            "fax_number": "716-626-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABBERFIELD",
        "first_name": "TEDD",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "011033",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NY",
            "license": "011033",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "011033",
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "NY",
            "license": "011033",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS HEALTH",
            "identifier": "20207801",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "6104050",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NOW",
            "identifier": "000511263001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.