Individual provider Active NPI

James R Bott

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1609056134
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
017272 Issued in NY
Practice address
315 W 57TH St Ste 410
New York, NY 10019-3147
Phone
(646) 285-8989
NPI assigned
Nov 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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 017272 NY Primary

Addresses

Primary practice location

315 W 57TH St Ste 410
New York, NY 10019-3147

Mailing address

315 W 57TH St Ste 410
New York, NY 10019-3147
Phone (646) 285-8989

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
I20080910000134 NY Practitioner - Clinical Psychologist 6305912635 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

130 W 57TH St
Apt 2F
New York, NY 10019-3314
Phone (917) 743-5563

315 W 57TH St
Suite 410
New York, NY 10019-3147
Phone (646) 282-8989

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017272NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194912000000",
    "number": "1609056134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W 57TH ST STE 410",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193147",
            "telephone_number": "646-285-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W 57TH ST STE 410",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193147",
            "telephone_number": "646-285-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTT",
        "first_name": "JAMES",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-13",
        "last_updated": "2007-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "017272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.