Individual provider Active NPI

Trudy-Ann Kimberley Gayle, PH.D.

  • Clinical Psychologist
  • Springfield Gardens, NY
National Provider Identifier
1497010698
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
021529 Issued in NY
Practice address
14335 182ND PL
Springfield Gardens, NY 11413-3222
Phone
(917) 858-8448
Fax
(718) 613-6438
NPI assigned
Jul 12, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 021529 NY Primary
Clinical Psychologist 103TC0700X P84622 NY

Addresses

Primary practice location

14335 182ND PL
Springfield Gardens, NY 11413-3222

Mailing address

14335 182ND PL
Springfield Gardens, NY 11413-3222
Phone (917) 858-8448

Other practice location 1

156 W 56th St Ste 1804
New York, NY 10019-3878
Phone (212) 851-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P84622NYMDClinical Psychologist
021529NYMDSports Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Life Matters Services Inc. CurrentSince Sep 29, 2024 Accepting new patients

Organizations & group practices 1

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": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1497010698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14335 182ND PL",
            "city": "SPRINGFIELD GARDENS",
            "state": "NY",
            "postal_code": "114133222",
            "telephone_number": "917-858-8448",
            "fax_number": "718-613-6438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14335 182ND PL",
            "city": "SPRINGFIELD GARDENS",
            "state": "NY",
            "postal_code": "114133222",
            "telephone_number": "917-858-8448",
            "fax_number": "718-613-6438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "156 W 56th St Ste 1804",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100193878",
            "country_code": "US",
            "telephone_number": "212-851-8100",
            "fax_number": "212-537-0102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAYLE",
        "first_name": "TRUDY-ANN",
        "middle_name": "KIMBERLEY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-12",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021529",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "P84622",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield Gardens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.