Carolyn Ryan, PHDLICMPHILMABCBAD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

018669-1 Issued in NY

Practice address

7822 Cloverdale Blvd
Unit B
Bayside, NY 11364-3124

Phone

(917) 335-2881

NPI assigned

Aug 28, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Che Senior Psychological Services, PCGroup PAC ID 8022905314, 227 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Che Senior Psychological Services, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1023078219
  Medicare reassignment Care Compare group NPD
• Knapp Street Psychiatry, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1043248776
  Medicare reassignment NPD

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

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1336516020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78-22 CLOVERDALE BLVD",
            "address_2": "UNIT B",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "11364",
            "telephone_number": "917-335-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7822 CLOVERDALE BLVD",
            "address_2": "UNIT B",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113643124",
            "telephone_number": "917-335-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "CAROLYN",
        "name_prefix": "Dr.",
        "credential": "PHDLICMPHILMABCBAD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-28",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "000048-1",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "018669-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose Rubin, PA
• Joshua Jay Rubinfeld, DMD
• Alan Rucker, RN
• Emelyn Mariana Ruiz Morales
• Joyce Theresa Ruocco
• Stephanie Ryan, MS, SP.ED.
• S J Pahng MD PC
• S. Klein MD LLC
• S.R.Occupational & Massage Therapy,PC
• Carol Saenz-Santamaria

• Psychologist in Bayside, NY
• Providers in Bayside, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.