Active NPI
Surrenca Albert, PSY.D
- Psychologist
- Forest Hills, NY
National Provider Identifier
1457903155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 023132
- Practice address
- 11020 71St Ave
Forest Hills, NY 11375-4553 - Phone
- (646) 580-6242
- NPI assigned
- Jul 12, 2019
- 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 | 023132 | NY | Primary |
Addresses
Primary practice location
11020 71St Ave
Forest Hills, NY 11375-4553
Mailing address
13312 234TH St
Rosedale, NY 11422-1314
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 |
|---|---|---|---|---|
| I20250830000352 | NY | Order and Referring Only - Clinical Psychologist | 9739680729 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 023132 | NY | MD | Physician Assistant |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562889600000",
"number": "1457903155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13312 234TH ST",
"city": "ROSEDALE",
"state": "NY",
"postal_code": "114221314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11020 71ST AVE",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113754553",
"telephone_number": "646-580-6242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALBERT",
"first_name": "SURRENCA",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-12",
"last_updated": "2019-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "023132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.