Individual provider Active NPI

Jonathan Ames, PHD

  • Psychologist
  • Ithaca, NY
National Provider Identifier
1609951656
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0150741 Issued in NY
Practice address
415 N Tioga St
#205
Ithaca, NY 14850-4228
Phone
(607) 273-1097
Fax
(866) 279-0654
NPI assigned
Oct 26, 2006
Last updated
May 10, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 0150741 NY Primary

Addresses

Primary practice location

415 N Tioga St
#205
Ithaca, NY 14850-4228

Mailing address

415 N Tioga St
#205
Ithaca, NY 14850-4228
Phone (607) 273-1097

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
I20070801000321 NY Practitioner - Clinical Psychologist 5597856831 Practice locations: Ithaca, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0150741NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Psychological Consultants PC Psychologist PastSince Mar 1, 2015 Accepting new patients

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1609951656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N TIOGA ST",
            "address_2": "#205",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504228",
            "telephone_number": "607-273-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N TIOGA ST",
            "address_2": "#205",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504228",
            "telephone_number": "607-273-1097",
            "fax_number": "866-279-0654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMES",
        "first_name": "JONATHAN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "0150741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.