Individual provider Active NPI

Edward Alan Schechtman, PHD

  • Clinical Psychologist
  • Commack, NY
National Provider Identifier
1407948334
Registry record updated Dec 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
012762 Issued in NY
Practice address
340 Veterans Memorial Hwy
Suite 2
Commack, NY 11725-4300
Phone
(631) 543-1234
Fax
(631) 858-0783
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2010

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 012762 NY Primary

Addresses

Primary practice location

340 Veterans Memorial Hwy
Suite 2
Commack, NY 11725-4300

Mailing address

PO Box 545
Commack, NY 11725-0545
Phone (631) 543-1234

Other identifiers 1

IdentifierTypeStateIssuer
01 902 487MedicaidNY

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
I20050309001053 NY Practitioner - Clinical Psychologist 3870547003 Practice locations: Commack, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

340 Veterans Memorial Hwy
Suite 2
Commack, NY 11725-4300
Phone (631) 499-4730

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291852800000",
    "number": "1407948334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 545",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117250545",
            "telephone_number": "631-543-1234",
            "fax_number": "631-858-0783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 2",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254300",
            "telephone_number": "631-543-1234",
            "fax_number": "631-858-0783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHECHTMAN",
        "first_name": "EDWARD",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2010-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "012762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01 902 487",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.