Individual provider Active NPI

Miriam Faye Krumholz, PSYD

  • Psychologist
  • San Francisco, CA
National Provider Identifier
1609531078
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
024429-01 Issued in NY
Practice address
833 Market St Ste 809
San Francisco, CA 94103-1828
Phone
(415) 627-9095
Fax
(415) 627-9108
NPI assigned
Nov 1, 2021
Last updated
Nov 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 024429-01 NY Primary

Addresses

Primary practice location

833 Market St Ste 809
San Francisco, CA 94103-1828

Mailing address

833 Market St Ste 809
San Francisco, CA 94103-1828
Phone (415) 627-9095

Other identifiers 1

IdentifierTypeStateIssuer
024429-01OtherNYPSYCHOLOGIST LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220803002429 CA Practitioner - Clinical Psychologist 1153703467 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
024429-01NYMDPsychologist
33368CAMDChiropractor

Organizations & group practices 1

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": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1609531078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 MARKET ST STE 809",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941031828",
            "telephone_number": "415-627-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 MARKET ST STE 809",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941031828",
            "telephone_number": "415-627-9095",
            "fax_number": "415-627-9108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUMHOLZ",
        "first_name": "MIRIAM",
        "middle_name": "FAYE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "024429-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST LICENSE",
            "identifier": "024429-01",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.