Kristen Eve Pollack-Dorta, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

014050 Issued in NY

Practice address

49 Smith Ave
Mount Kisco, NY 10549-2813

Phone

(917) 539-4583

NPI assigned

Oct 23, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinical Psychassociates LLPGroup PAC ID 3072404888, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Clinical Psychassociates LLP

  • Clinical Psychologist
  • New York, NY
  • NPI 1124051925

  NY

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1497537617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 UPPER LAKESHORE DR",
            "city": "KATONAH",
            "state": "NY",
            "postal_code": "105362646",
            "telephone_number": "917-539-4583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 SMITH AVE",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105492813",
            "telephone_number": "917-539-4583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLACK-DORTA",
        "first_name": "KRISTEN",
        "middle_name": "EVE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "014050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camille Platzek, REGISTERED NURSE
• Playmates Behavior Analysis
• Pleasantville Physical Therapy Sports Care PC,
• Daniil Pogosov, PHARMD
• Carla M Polcyn, MD123158
• Barbara Polowczyk, FNP
• Yelena Polyakova, D.C.
• Michelle Rachel Popkin, MD
• Ariel Walsh Porteus, CASAC-T
• Jeffrey S Powell, MD

• All providers in Mount Kisco, NY
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.