Active NPI
Nicholas Demas, PH.D.
- Clinical Psychologist
- New York, NY
National Provider Identifier
1477214823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 024731
- Practice address
- 150 E 58TH St FL 5
New York, NY 10155-0002 - Phone
- (212) 308-2440
- NPI assigned
- Jan 7, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 024731 | NY | Primary |
Addresses
Primary practice location
150 E 58TH St FL 5
New York, NY 10155-0002
Mailing address
2730 Remsen St
Baldwin, NY 11510-3830
Phone (718) 812-3091
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 024731 | Other | NY | NEW YORK STATE PSYCHOLOGY LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 27, 2023 through Apr 27, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024731 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641513600000",
"number": "1477214823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2730 REMSEN ST",
"city": "BALDWIN",
"state": "NY",
"postal_code": "115103830",
"telephone_number": "718-812-3091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 E 58TH ST FL 5",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101550002",
"telephone_number": "212-308-2440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMAS",
"first_name": "NICHOLAS",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-01-07",
"last_updated": "2022-01-07",
"certification_date": "2022-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "024731",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW YORK STATE PSYCHOLOGY LICENSE",
"identifier": "024731",
"state": "NY"
}
],
"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 Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.