Organization Active NPI

Cheryl S Chitayat Psy D PC

  • Clinical Psychologist
  • Commack, NY
National Provider Identifier
1356563431
Registry record updated Feb 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
009723 Issued in NY
Legal business name
CHERYL S CHITAYAT PSY D PC
Practice address
358 Veterans Memorial Hwy.
Suite 12
Commack, NY 11725-4332
Phone
(631) 864-5535
NPI assigned
May 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2018

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

Authorized official

Name
Dr. Cheryl S. Chitayat, PSY.D.NPI 1508088667
Title
President
Phone
(631) 864-5535

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X 009723 NY
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X 009723 NY Primary
Clinical Child & Adolescent PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC2200X 009723 NY

Addresses

Primary practice location

358 Veterans Memorial Hwy.
Suite 12
Commack, NY 11725-4332

Mailing address

358 Veterans Memorial Hwy.
Suite 12
Commack, NY 11725-4332
Phone (631) 864-5535

Other identifiers 1

IdentifierTypeStateIssuer
S09723-8OtherNYWCB#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120904000034 NY Part B Supplier - Clinic/Group Practice 9234386848 Receives reassigned benefits from 1 practitioner
Practice locations: Commack, NY

National Provider Directory

National Provider Directory

Locations

358 Veterans Memorial Hwy
Ste 12
Commack, NY 11725
Phone (631) 656-6055

356 Veterans Memorial Hwy
Ste 6
Commack, NY 11725
Phone (631) 486-0026

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518134400000",
    "number": "1356563431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 VETERANS MEMORIAL HWY.",
            "address_2": "SUITE 12",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254332",
            "telephone_number": "631-864-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 VETERANS MEMORIAL HWY.",
            "address_2": "SUITE 12",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254332",
            "telephone_number": "631-864-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERYL S CHITAYAT PSY D PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2018-02-09",
        "status": "A",
        "authorized_official_last_name": "CHITAYAT",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-864-5535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NY",
            "license": "009723",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "009723",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "009723",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WCB#",
            "identifier": "S09723-8",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.