Individual provider Active NPI

Henry Bob Hartman, PH.D.

  • Clinical Psychologist
  • White Plains, NY
National Provider Identifier
1487649380
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
006310 Issued in NY
Practice address
12 Old Mamaroneck Rd
White Plains, NY 10605-2010
Phone
(914) 761-6868
Fax
(914) 761-7213
NPI assigned
Sep 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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 006310 NY Primary

Addresses

Primary practice location

12 Old Mamaroneck Rd
White Plains, NY 10605-2010

Mailing address

12 Old Mamaroneck Rd
White Plains, NY 10605-2010
Phone (914) 761-6868

Other identifiers 1

IdentifierTypeStateIssuer
00538505MedicaidNY

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
I20091016000069 NY Practitioner - Clinical Psychologist 8628115029 Practice locations: White Plains, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

12 Old Mamaroneck Rd
White Plains, NY 10605-2010

12 Old Mamaroneck Rd
Suite 1D
White Plains, NY 10605-2025
Phone (914) 761-6868

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
006310NYMDRegistered Dietitian

Networks

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

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220486400000",
    "number": "1487649380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 OLD MAMARONECK RD",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106052010",
            "telephone_number": "914-761-6868",
            "fax_number": "914-761-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 OLD MAMARONECK RD",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106052010",
            "telephone_number": "914-761-6868",
            "fax_number": "914-761-7213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "HENRY",
        "middle_name": "BOB",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2008-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "006310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00538505",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.