Active NPI
Estelle B. Wade, PH.D.
- Psychologist
- New York, NY
National Provider Identifier
1457400459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4143
- Practice address
- 141 E 55TH St
Suite 9B
New York, NY 10022-4030 - Phone
- (212) 935-1213
- NPI assigned
- Jan 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4143 | NY | Primary |
Addresses
Primary practice location
141 E 55TH St
Suite 9B
New York, NY 10022-4030
Mailing address
PO Box 7654
FDR Station
New York, NY 10150-7654
Phone (212) 935-1213
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| V1761 | Other | NY | EMPIRE BLUECROSS BLUESHIE |
| 0004481621 | Other | AETNA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050630000105 | NY | Practitioner - Clinical Psychologist | 5698711638 | Practice locations: New York, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1971
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
141 E 55TH St
9B
New York, NY 10022-4032
Phone (212) 935-1213
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4143 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268092800000",
"number": "1457400459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7654",
"address_2": "FDR STATION",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101507654",
"telephone_number": "212-935-1213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 E 55TH ST",
"address_2": "SUITE 9B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100224030",
"telephone_number": "212-935-1213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "ESTELLE",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-09",
"last_updated": "2010-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "4143",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BLUECROSS BLUESHIE",
"identifier": "V1761",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0004481621",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.