Active NPI
Adena E Shoshan, PSYD
- Psychologist
- Rochester, NY
National Provider Identifier
1407103252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 019295
- Practice address
- 160 Allens Creek Rd
Rochester, NY 14618-3309 - Phone
- (585) 454-9904
- Fax
- (585) 286-4487
- NPI assigned
- Aug 11, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 019295 | NY | Primary |
Addresses
Primary practice location
160 Allens Creek Rd
Rochester, NY 14618-3309
Mailing address
160 Allens Creek Rd
Rochester, NY 14618-3309
Phone (585) 454-9904
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12423485 | Other | CAQH |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
27 Aldwick Rise
Fairport, NY 14450-3801
Phone (585) 454-9904
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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.
-
- Clinical Psychologist
- Penfield, NY
- NPI 1821500174
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344643200000",
"number": "1407103252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 ALLENS CREEK RD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146183309",
"telephone_number": "585-454-9904",
"fax_number": "585-286-4487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 ALLENS CREEK RD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146183309",
"telephone_number": "585-454-9904",
"fax_number": "585-286-4487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOSHAN",
"first_name": "ADENA",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-11",
"last_updated": "2012-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "019295",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "12423485",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2012; 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.