Individual provider Active NPI

Jill Thistlethwaite, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1407911902
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
007451 Issued in NY
Practice address
156 5TH Ave
Suite 720
New York, NY 10010-7002
Phone
(212) 337-9596
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 007451 NY Primary

Addresses

Primary practice location

156 5TH Ave
Suite 720
New York, NY 10010-7002

Mailing address

144 E 7TH St
Apt. C-12
New York, NY 10009-6203
Phone (212) 982-5247

Other identifiers 1

IdentifierTypeStateIssuer
01132934MedicaidNY

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
I20040223000004 NY Practitioner - Clinical Psychologist 4789579376 Reassigns benefits to 1 organization
Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Fordham University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

144 E 7TH St
Apt C12
New York, NY 10009-6254
Phone (212) 982-5247

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
007451NYMDAcupuncturist

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

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.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1407911902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 E 7TH ST",
            "address_2": "APT. C-12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100096203",
            "telephone_number": "212-982-5247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 5TH AVE",
            "address_2": "SUITE 720",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100107002",
            "telephone_number": "212-337-9596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THISTLETHWAITE",
        "first_name": "JILL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "007451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01132934",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.