Individual provider Active NPI

Vega Lalire, PHD

  • Clinical Psychologist
  • Goshen, NY
National Provider Identifier
1508953811
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
008221 Issued in NY
Practice address
261 Greenwich Ave
Goshen, NY 10924-2028
Phone
(845) 615-1004
Fax
(845) 615-1029
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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 008221 NY Primary

Addresses

Primary practice location

261 Greenwich Ave
Goshen, NY 10924-2028

Mailing address

17 Squadron Blvd
New City, NY 10956-5214
Phone (845) 213-1495

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
I20090514000386 NY Practitioner - Clinical Psychologist 8123177573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of New Mexico School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

261 Greenwich Ave
Goshen, NY 10924-2028
Phone (845) 754-4472

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008221NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
John J Lucas M D P C CurrentSince May 1, 2009 Accepting new patients

Locations

17 Squadron Blvd
Ste 400
New City, NY 10956

Organizations & group practices 2

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1508953811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SQUADRON BLVD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109565214",
            "telephone_number": "845-213-1495",
            "fax_number": "845-634-9424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 GREENWICH AVE",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109242028",
            "telephone_number": "845-615-1004",
            "fax_number": "845-615-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LALIRE",
        "first_name": "VEGA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "008221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, NY

Sources for this page

Verify at the official NPI Registry.