Individual provider Active NPI

Anjana Jagpal

  • Clinical Child & Adolescent Psychologist
  • New York, NY
National Provider Identifier
1477238392
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
025773 Issued in NY
Practice address
1300 York Ave # 65
New York, NY 10065-4805
Phone
(212) 746-5454
NPI assigned
Jun 19, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Health Psychologist 103TH0004X NY
Clinical Psychologist 103TC0700X 025773 NY
Clinical Child & Adolescent Psychologist 103TC2200X 025773 NY Primary

Addresses

Primary practice location

1300 York Ave # 65
New York, NY 10065-4805

Mailing address

1300 York Ave # 65
New York, NY 10065-4805

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
I20240116000494 NY Practitioner - Clinical Psychologist 2668824665 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, shared by 46 NPIs, 2,023 clinicians

Practice addresses (Care Compare)

525 E 68TH St
New York, NY 10065-4870
Phone (646) 962-3376

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
025773NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Dec 5, 2023 Accepting new patients
Weill Medical College of Cornell CurrentSince Nov 11, 2024 Accepting new patients
Weill Medical College of Cornell CurrentSince Dec 5, 2023 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients

Locations

525 E 68th St
#M6
New York, NY 10065
Phone (212) 746-3558

156 William St
New York, NY 10038
Phone (646) 962-4679

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

1300 York Ave
#65
New York, NY 10065
Phone (212) 746-6565

21 Bloomingdale Rd
White Plains, NY 10605
Phone (914) 682-9100

Networks

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

Organizations & group practices 4

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": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1477238392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 YORK AVE # 65",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 YORK AVE # 65",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654805",
            "telephone_number": "212-746-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGPAL",
        "first_name": "ANJANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "025773",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "025773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.