Individual provider Active NPI

Abigail Gleason, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1316960719
Registry record updated Jun 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
13693 Issued in NY
Practice address
1745 Broadway
17 FL
New York, NY 10019-4640
Phone
(212) 851-8100
Fax
(212) 537-0102
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2015

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 13693 NY Primary

Addresses

Primary practice location

1745 Broadway
17 FL
New York, NY 10019-4640

Mailing address

60 Sherwood Ave
Ossining, NY 10562-3547
Phone (845) 975-8719

Other identifiers 1

IdentifierTypeStateIssuer
01999742MedicaidNY

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
I20101230000907 NY Practitioner - Clinical Psychologist 0941498224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinical Psychassociates LLPGroup PAC ID 3072404888, 33 clinicians

Practice addresses (Care Compare)

2000 E Gun Hill Rd
Bronx, NY 10469-6016
Phone (718) 320-0400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13693NYMDClinical Psychologist
013693NYMDSurgical Physician Assistant

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433894400000",
    "number": "1316960719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 SHERWOOD AVE",
            "city": "OSSINING",
            "state": "NY",
            "postal_code": "105623547",
            "telephone_number": "845-975-8719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 BROADWAY",
            "address_2": "17 FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100194640",
            "telephone_number": "212-851-8100",
            "fax_number": "212-537-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "ABIGAIL",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2015-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "13693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01999742",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.