Individual provider Active NPI

Rachel Weller, PSYD.

  • Psychologist
  • New York, NY
National Provider Identifier
1366813347
Registry record updated Sep 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
023273 Issued in NY
Practice address
321 E 96TH St
New York, NY 10128-3804
Phone
(818) 925-4450
NPI assigned
Oct 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychologist 103T00000X 023273 NY Primary

Addresses

Primary practice location

321 E 96TH St
New York, NY 10128-3804

Mailing address

411 W 114TH St FL 2
New York, NY 10025-1710
Phone (805) 405-5311

Other practice location 1

4025 W 226th St
Torrance, CA 90505-2340
Phone (310) 791-3387

Other practice location 2

411 W 114th St Fl 2
New York, NY 10025-1710
Phone (212) 523-1067

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
I20191108002104 NY Practitioner - Clinical Psychologist 5698107811 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 15, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 15, 2019 Accepting new patients

Locations

150 E 42nd St
Frnt F
New York, NY 10017

1425 Madison Ave
New York, NY 10029
Phone (212) 824-8150

Organizations & group practices 2

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": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725753600000",
    "number": "1366813347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W 114TH ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251710",
            "telephone_number": "805-405-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 E 96TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101283804",
            "telephone_number": "818-925-4450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4025 W 226th St",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905052340",
            "country_code": "US",
            "telephone_number": "310-791-3387",
            "fax_number": "310-791-3387",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "411 W 114th St Fl 2",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100251710",
            "country_code": "US",
            "telephone_number": "212-523-1067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLER",
        "first_name": "RACHEL",
        "credential": "PSYD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-15",
        "last_updated": "2024-09-08",
        "certification_date": "2024-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "023273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.