Individual provider Active NPI

Roya Amirniroumand, PHD

  • Clinical Child & Adolescent Psychologist
  • New York, NY
National Provider Identifier
1457076804
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
025574 Issued in NY
Practice address
1 Park Ave FL 7
New York, NY 10016-5818
Phone
(646) 754-5000
NPI assigned
Oct 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 025574 NY
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Child & Adolescent Psychologist 103TC2200X 025574 NY Primary

Addresses

Primary practice location

1 Park Ave FL 7
New York, NY 10016-5818

Mailing address

1 Park Ave FL 7
New York, NY 10016-5818
Phone (646) 754-5000

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
I20230525003326 NY Practitioner - Clinical Psychologist 0345606836 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025574NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Apr 18, 2023 Accepting new patients
New York University CurrentSince Apr 18, 2023 Accepting new patients

Locations

1 Park Ave
Fl 7
New York, NY 10016
Phone (646) 754-5000

Networks

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

Organizations & group practices 2

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": "1665100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1457076804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PARK AVE FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165818",
            "telephone_number": "646-754-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARK AVE FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165818",
            "telephone_number": "646-754-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIRNIROUMAND",
        "first_name": "ROYA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-07",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "025574",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "025574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.