Individual provider Active NPI

Cheryl Henrietta Cottrol, M.D.

  • Neurology Physician
  • New York, NY
National Provider Identifier
1417091356
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
161569 Issued in NY
Practice address
347 W 57TH St
New York, NY 10019-3173
Phone
(888) 384-5554
Fax
(866) 529-5039
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 33177 CT
Neurology Physician 2084N0400X 161569 NY Primary

Addresses

Primary practice location

347 W 57TH St
New York, NY 10019-3173

Mailing address

347 W 57TH St
New York, NY 10019-3173
Phone (212) 369-2395

Other practice location 1

982 E Main St
Bridgeport, CT 06608-1913
Phone (203) 696-3260

Other practice location 2

332 E 14th St
New York, NY 10003-4243
Phone (212) 481-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070905000038 NY Practitioner - PsychiatryPractitioner - Neurology 8729171947 Practice locations: New York, NY
I20111114000208 CT Practitioner - PsychiatryPractitioner - Neurology 8729171947 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33177CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allbrainmd PLLC CurrentSince Nov 19, 2023 Accepting new patients
Affiliate of Neurology & Psychiatry, PLLC Neurology CurrentSince Nov 21, 2021 Accepting new patients
Connecticut Mental Health Specialists Inc Psychiatry CurrentSince Nov 4, 2018 Accepting new patients
Teladoc Health Medical Group, P.a. Psychiatry Current Accepting new patients
Optimus Health Care Inc CurrentSince Apr 1, 2019 Accepting new patients
Arnot Ogden Medical Center Psychiatry Past Accepting new patients

Locations

982 E Main St
Bridgeport, CT 06608
Phone (203) 696-3260

471 Barnum Ave
Bridgeport, CT 06608
Phone (203) 333-6864

270 Farmington Ave
Ste 309
Farmington, CT 06032
Phone (860) 677-5570

1351 Washington Blvd
Stamford, CT 06902
Phone (203) 276-7464

Networks

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

Interoperability endpoints

  • Direct secure messaging: cheryl.cottrol.2@13555.direct.athenahealth.com
  • Direct secure messaging: cherylcottrol@tdh.allscriptsdirect.net

Organizations & group practices 6

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": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1417091356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 W 57TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193173",
            "telephone_number": "212-369-2395",
            "fax_number": "866-529-5039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 W 57TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193173",
            "telephone_number": "888-384-5554",
            "fax_number": "866-529-5039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "982 E Main St",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "066081913",
            "country_code": "US",
            "telephone_number": "203-696-3260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "332 E 14th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100034243",
            "country_code": "US",
            "telephone_number": "212-481-3333",
            "fax_number": "212-253-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COTTROL",
        "first_name": "CHERYL",
        "middle_name": "HENRIETTA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "33177",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "161569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.