Individual provider Active NPI

Charles M Zaroff, PH.D.

  • Clinical Neuropsychologist
  • New York, NY
National Provider Identifier
1558378935
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
015052 Issued in NY
Practice address
104 E 40TH St
Ste 607
New York, NY 10016-1801
Phone
(212) 725-8511
Fax
(212) 726-7417
NPI assigned
Aug 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 015052 NY Primary

Addresses

Primary practice location

104 E 40TH St
Ste 607
New York, NY 10016-1801

Mailing address

104 E 40TH St
Ste 607
New York, NY 10016-1801
Phone (212) 725-8511

Other identifiers 1

IdentifierTypeStateIssuer
2802548MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, NE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201112003433 AK Practitioner - Clinical Psychologist 2163459363 Reassigns benefits to 1 organization
I20220201002155 NE Practitioner - Clinical Psychologist 2163459363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alaska Neurology Center LLCGroup PAC ID 2163512328, 7 clinicians

Practice addresses (Care Compare)

1100 E Dimond Blvd
Anchorage, AK 99515-2010
Phone (907) 565-6000

Merit-based Incentive Payment System (MIPS)

Final score
88.15 of 100Reported as group
Quality
69.59
Promoting interoperability
99
Improvement activities
40
Cost
75.1

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1072NEMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Neurology Center LLC CurrentSince May 5, 2020 Accepting new patients
Father Flanagan's Boys' Home CurrentSince Feb 7, 2022 Accepting new patients
ENT Services PC Past Accepting new patients

Locations

1100 E Dimond Blvd
Anchorage, AK 99515
Phone (907) 565-6000

14080 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (402) 778-6900

555 N 30th St
Omaha, NE 68131
Phone (402) 280-8100

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558378935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E 40TH ST",
            "address_2": "STE 607",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100161801",
            "telephone_number": "212-725-8511",
            "fax_number": "212-726-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E 40TH ST",
            "address_2": "STE 607",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100161801",
            "telephone_number": "212-725-8511",
            "fax_number": "212-726-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAROFF",
        "first_name": "CHARLES",
        "middle_name": "M",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "015052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2802548",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.