NPIMap

Organization Active NPI

Rubenzahl, Knudsen & Associates Psych., Srvcs, P.C.

  • Psychologist
  • Watertown, NY
National Provider Identifier
1578552170
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
009513 Issued in NY
Legal business name
RUBENZAHL, KNUDSEN & ASSOCIATES PSYCH., SRVCS, P.C.
Practice address
22670 Summit Drive
Suite 2
Watertown, NY 13601
Phone
(315) 788-3332
Fax
(315) 788-4584
NPI assigned
Oct 17, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Authorized official

Name
Thomas E. Knudsen, PSY.D.NPI 1841256716
Title
Owner
Phone
(315) 788-3332

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 009513 NY Primary

Addresses

Primary practice location

22670 Summit Drive
Suite 2
Watertown, NY 13601

Mailing address

22670 Summit Drive
Suite 2
Watertown, NY 13601
Phone (315) 788-3332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040924000837 NY Part B Supplier - Clinic/Group Practice 2860461076 Receives reassigned benefits from 5 practitioners
Practice locations: Watertown, NY

National Provider Directory

National Provider Directory

Locations

22670 Summit Dr
Ste 2
Watertown, NY 13601
Phone (315) 772-3332

531 Washington St
#2
Watertown, NY 13601
Phone (315) 788-3332

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411689600000",
    "number": "1578552170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22670 SUMMIT DRIVE",
            "address_2": "SUITE 2",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "13601",
            "telephone_number": "315-788-3332",
            "fax_number": "315-788-4584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22670 SUMMIT DRIVE",
            "address_2": "SUITE 2",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "13601",
            "telephone_number": "315-788-3332",
            "fax_number": "315-788-4584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUBENZAHL, KNUDSEN & ASSOCIATES PSYCH., SRVCS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-17",
        "last_updated": "2014-09-26",
        "status": "A",
        "authorized_official_last_name": "KNUDSEN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-788-3332",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NY",
            "license": "009513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.