Individual provider Active NPI

Leanne Domash, PH.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1437460722
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4388 Issued in NY
Practice address
77 E 12TH St
Apt 19D
New York, NY 10003-5002
Phone
(212) 982-6672
NPI assigned
Jul 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4388 NY Primary

Addresses

Primary practice location

77 E 12TH St
Apt 19D
New York, NY 10003-5002

Mailing address

77 E 12TH St
Apt 19D
New York, NY 10003-5002
Phone (212) 982-6672

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 1, 2012 through Jul 1, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4388NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Leanne Domash, PH.D., P.C. Psychologist PastSince Jul 1, 1990 Accepting new patients

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": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1437460722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 E 12TH ST",
            "address_2": "APT 19D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100035002",
            "telephone_number": "212-982-6672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 E 12TH ST",
            "address_2": "APT 19D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100035002",
            "telephone_number": "212-982-6672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMASH",
        "first_name": "LEANNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-01",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "4388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.