Individual provider Active NPI

Ilyssa Melanie Kaplan

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1396319588
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
024534 Issued in NY
Practice address
1641 3Rd Ave Apt 23C
New York, NY 10128-3632
Phone
(732) 570-9041
NPI assigned
May 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 024534 NY
Clinical Psychologist 103TC0700X 024534 NY Primary

Addresses

Primary practice location

1641 3Rd Ave Apt 23C
New York, NY 10128-3632

Mailing address

370 Lexington Ave RM 1200
New York, NY 10017-6584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 11, 2024 through Dec 11, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1396319588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 LEXINGTON AVE RM 1200",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 3RD AVE APT 23C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101283632",
            "telephone_number": "732-570-9041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPLAN",
        "first_name": "ILYSSA",
        "middle_name": "MELANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-13",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "024534",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.