NPIMap

Organization Active NPI

Adult Care Psychology Services, PLLC

Doing business as Adult Care Services

  • Clinical Psychologist
  • Flushing, NY
National Provider Identifier
1609935444
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
ADULT CARE PSYCHOLOGY SERVICES, PLLC
Doing business as
Adult Care Services
Practice address
13711 73Rd Ter
Flushing, NY 11367-2303
Phone
(718) 575-3510
Fax
(718) 575-0391
NPI assigned
Dec 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Authorized official

Name
Dr. Mark Kutner, PH.D.NPI 1700944782
Title
Executive Director
Phone
(718) 575-3510

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
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

13711 73Rd Ter
Flushing, NY 11367-2303

Mailing address

13711 73Rd Ter
Flushing, NY 11367-2303
Phone (718) 575-3510

Other identifiers 6

IdentifierTypeStateIssuer
02164212MedicaidNY
000409099OtherUNITED BEHAVIORAL HEALTH
678886OtherVALUE OPTIONS
403672OtherEMBLEM HEALTH
7379731OtherNYAETNA
814181000OtherNYMAGELLAN

Other names 1

  • Adult Care Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080530000484 NY Part B Supplier - Clinic/Group Practice 7911898747 Receives reassigned benefits from 5 practitioners
Practice locations: Fresh Meadows, NY; Staten Island, NY; Rego Park, NY; Forest Hills, NY; Far Rockaway, NY; Brooklyn, NY

National Provider Directory

National Provider Directory

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": "1165449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337731200000",
    "number": "1609935444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13711 73RD TER",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672303",
            "telephone_number": "718-575-3510",
            "fax_number": "718-575-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13711 73RD TER",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672303",
            "telephone_number": "718-575-3510",
            "fax_number": "718-575-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT CARE PSYCHOLOGY SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-07",
        "last_updated": "2012-05-23",
        "status": "A",
        "authorized_official_last_name": "KUTNER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "718-575-3510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02164212",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "000409099",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "678886",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMBLEM HEALTH",
            "identifier": "403672",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7379731",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "814181000",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adult Care Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; 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.