Individual provider Active NPI

Mary Coughtry, PSYD

  • Clinical Psychologist
  • Rochester, NY
National Provider Identifier
1467608034
Registry record updated Jan 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
012696 Issued in NY
Practice address
81 Lake Ave
Rochester, NY 14608-1410
Phone
(585) 368-6900
NPI assigned
Aug 14, 2008
Last updated
Jan 16, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 012696 NY Primary

Addresses

Primary practice location

81 Lake Ave
Rochester, NY 14608-1410

Mailing address

81 Lake Ave
Rochester, NY 14608-1410
Phone (585) 368-6900

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
I20081206000009 NY Practitioner - Clinical Psychologist 0941361166 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Unity Hospital of RochesterGroup PAC ID 9436060969, 732 clinicians

Practice addresses (Care Compare)

81 Lake Ave
Rochester, NY 14608-1410
Phone (585) 368-6900

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012696NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Network, Inc. CurrentSince Dec 25, 2020 Accepting new patients

Locations

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

490 E Ridge Rd
Rochester, NY 14621
Phone (585) 922-2500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1467608034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 LAKE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146081410",
            "telephone_number": "585-368-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 LAKE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146081410",
            "telephone_number": "585-368-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUGHTRY",
        "first_name": "MARY",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-14",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "012696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.