Active NPI
Jeffrey Steven Nevid, PH.D.
- Clinical Psychologist
- New York, NY
National Provider Identifier
1477769719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 005716
- Practice address
- 382 Central Park W
#11D
New York, NY 10025-6054 - Phone
- (212) 678-7722
- Fax
- (718) 990-6705
- NPI assigned
- May 15, 2007
- 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 | 005716 | NY | Primary |
Addresses
Primary practice location
382 Central Park W
#11D
New York, NY 10025-6054
Mailing address
382 Central Park W
#11D
New York, NY 10025-6054
Phone (212) 678-7722
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230629003064 | NY | Practitioner - Psychologist Billing Independently | 1557720182 | Practice locations: New York, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005716 | NY | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465171200000",
"number": "1477769719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "382 CENTRAL PARK W",
"address_2": "#11D",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100256054",
"telephone_number": "212-678-7722",
"fax_number": "718-990-6705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "382 CENTRAL PARK W",
"address_2": "#11D",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100256054",
"telephone_number": "212-678-7722",
"fax_number": "718-990-6705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEVID",
"first_name": "JEFFREY",
"middle_name": "STEVEN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-15",
"last_updated": "2016-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "005716",
"primary": true
}
],
"identifiers": [],
"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 Jun 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.