Individual provider Active NPI

Andrew Monteverde Elmore, PH.D.

  • Forensic Psychologist
  • New York, NY
National Provider Identifier
1558577338
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic PsychologistTaxonomy code 103TF0200X
License
05698 Issued in NY
Practice address
401 E 80TH St
Suite 28G
New York, NY 10021-0655
Phone
(212) 535-5813
Fax
(212) 535-5813
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 06598 NY
Clinical Psychologist 103TC0700X 06598 NY
Forensic Psychologist 103TF0200X 05698 NY Primary
Health Psychologist 103TH0004X 06598 NY

Addresses

Primary practice location

401 E 80TH St
Suite 28G
New York, NY 10021-0655

Mailing address

401 E 80TH St
Suite 28G
New York, NY 10021-0655
Phone (212) 535-5813

Other identifiers 1

IdentifierTypeStateIssuer
S06598-7BOtherNYWORKERS' COMPENSATION BOA

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
I20101109000286 NY Practitioner - Clinical Psychologist 9335334903 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

401 E 80TH St
New York, NY 10075-0646
Phone (212) 535-5813

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05698NYMDForensic Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1558577338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E 80TH ST",
            "address_2": "SUITE 28G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100210655",
            "telephone_number": "212-535-5813",
            "fax_number": "212-535-5813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E 80TH ST",
            "address_2": "SUITE 28G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100210655",
            "telephone_number": "212-535-5813",
            "fax_number": "212-535-5813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMORE",
        "first_name": "ANDREW",
        "middle_name": "MONTEVERDE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NY",
            "license": "06598",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "06598",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "NY",
            "license": "05698",
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "NY",
            "license": "06598",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS' COMPENSATION BOA",
            "identifier": "S06598-7B",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.