Individual provider Active NPI

Sarrah Bronson, PHD

  • Clinical Psychologist
  • Kingston, NY
National Provider Identifier
1477632297
Registry record updated Oct 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
8140 Issued in NY
Practice address
275 Fair St Ste 17B
Kingston, NY 12401-3882
Phone
(914) 391-7078
NPI assigned
Nov 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 8140 NY
Clinical Psychologist 103TC0700X 8140 NY Primary
Clinical Neuropsychologist 103G00000X 8140 NY

Addresses

Primary practice location

275 Fair St Ste 17B
Kingston, NY 12401-3882

Mailing address

4D Holland Dr
West Hurley, NY 12491-5615
Phone (914) 391-7078

Other practice location 1

4D Holland Dr
West Hurley, NY 12491-5615
Phone (914) 391-7078

Other identifiers 4

IdentifierTypeStateIssuer
02009938MedicaidNY
81448OtherNYVALUE BEHAVIORAL HEALTH
P523165OtherNYOXFORD HEALTH PLANS
72992OtherNYGHI

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
I20070511000523 NY Practitioner - Clinical Psychologist 0840397642 Practice locations: Kingston, NY; Bayside, NY; New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

21245 26TH Ave
Suite 4a
Bayside, NY 11360-1901
Phone (212) 439-1057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
8140NYMDClinical Neuropsychologist
008140NYMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697328000000",
    "number": "1477632297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4D HOLLAND DR",
            "city": "WEST HURLEY",
            "state": "NY",
            "postal_code": "124915615",
            "telephone_number": "914-391-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 FAIR ST STE 17B",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013882",
            "telephone_number": "914-391-7078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4D Holland Dr",
            "address_purpose": "LOCATION",
            "city": "West Hurley",
            "state": "NY",
            "postal_code": "124915615",
            "country_code": "US",
            "telephone_number": "914-391-7078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRONSON",
        "first_name": "SARRAH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2023-10-15",
        "certification_date": "2023-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "8140",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "8140",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "8140",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02009938",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE BEHAVIORAL HEALTH",
            "identifier": "81448",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "P523165",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "72992",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.