Individual provider Active NPI

Cheryl S. Chitayat, PSY.D.

  • Clinical Psychologist
  • Commack, NY
National Provider Identifier
1508088667
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
009723 Issued in NY
Practice address
358 Veterans Memorial Hwy.
Suite 12
Commack, NY 11725-4332
Phone
(631) 864-5535
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 009723 NY
Clinical Child & Adolescent Psychologist 103TC2200X 009723 NY
Clinical Psychologist 103TC0700X 009723 NY Primary

Addresses

Primary practice location

358 Veterans Memorial Hwy.
Suite 12
Commack, NY 11725-4332

Mailing address

358 Veterans Memorial Hwy.
Suite 12
Commack, NY 11725-4332
Phone (631) 864-5535

Other identifiers 1

IdentifierTypeStateIssuer
S09723-8OtherNYWCB#

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
I20120910000051 NY Practitioner - Clinical Psychologist 5496902009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

356 Veterans Memorial Hwy
Suite 6
Commack, NY 11725-4332
Phone (631) 864-5535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009723NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cheryl S Chitayat Psy D PC Psychologist CurrentSince Jul 12, 2012 Accepting new patients

Locations

358 Veterans Memorial Hwy
Ste 12
Commack, NY 11725
Phone (631) 656-6055

356 Veterans Memorial Hwy
Ste 6
Commack, NY 11725
Phone (631) 486-0026

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1508088667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 VETERANS MEMORIAL HWY.",
            "address_2": "SUITE 12",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254332",
            "telephone_number": "631-864-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 VETERANS MEMORIAL HWY.",
            "address_2": "SUITE 12",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254332",
            "telephone_number": "631-864-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHITAYAT",
        "first_name": "CHERYL",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "009723",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "009723",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "009723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WCB#",
            "identifier": "S09723-8",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.