Individual provider Active NPI

Jonathan Kratter, PHD

  • Clinical Psychologist
  • Melville, NY
National Provider Identifier
1558642884
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
007789 Issued in NY
Practice address
25 Melville Park Rd # 224
Melville, NY 11747-3175
Phone
(516) 435-6314
NPI assigned
Aug 31, 2011
Last updated
Oct 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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 007789 NY Primary

Addresses

Primary practice location

25 Melville Park Rd # 224
Melville, NY 11747-3175

Mailing address

420 Stonecrop Rd
Riverhead, NY 11901-1220
Phone (516) 435-6314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1558642884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 STONECROP RD",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119011220",
            "telephone_number": "516-435-6314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MELVILLE PARK RD # 224",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117473175",
            "telephone_number": "516-435-6314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRATTER",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-31",
        "last_updated": "2020-10-25",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "007789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.