Joseph E Chruscicki, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

215576 Issued in NY

Practice address

141 Sullys TRL
Ste 5B
Pittsford, NY 14534-4563

Phone

(585) 368-6550

Fax

(585) 368-6540

NPI assigned

May 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Suburban Psychiatric Associates, LLP

  • Psychiatry Physician
  • Amherst, NY
  • NPI 1851331367
  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1609879410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 SULLYS TRL",
            "address_2": "STE 5B",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145344563",
            "telephone_number": "585-368-6550",
            "fax_number": "585-368-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 SULLYS TRL",
            "address_2": "STE 5B",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145344563",
            "telephone_number": "585-368-6550",
            "fax_number": "585-368-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRUSCICKI",
        "first_name": "JOSEPH",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "215576",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "215576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10989059",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00027056901",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "1512813",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH INTEGRATED",
            "identifier": "000528054001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chrysa Lynn Charno, P.A.
• Lynn Chauvin-Bezinque
• Muhammad Azam Cheema, M.D.
• Leslie Courtemanche Childs, REGISTERED PROFFESIO
• Christine Kaiser LCSW PLLC
• Chung H. Kim MD, PC
• Louis Joseph Cianca, DDS
• Eileen Ciavaglia, DPT
• Brigid Amico Clark, LPN
• Lakisha Juanita Clark, LPN

• Child & Adolescent Psychiatry Physician in Pittsford, NY
• Providers in Pittsford, NY by specialty
• Child & Adolescent Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.