Individual provider Active NPI

David Joshua Shumsky, PSY.D.

  • Clinical Psychologist
  • Fishkill, NY
National Provider Identifier
1619967668
Registry record updated Jul 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
009554-1 Issued in NY
Practice address
21 Old Main St
Suite 204
Fishkill, NY 12524-1883
Phone
(845) 897-4100
Fax
(845) 897-4100
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2012

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 009554-1 NY Primary

Addresses

Primary practice location

21 Old Main St
Suite 204
Fishkill, NY 12524-1883

Mailing address

21 Old Main St
Suite 204
Fishkill, NY 12524-1883
Phone (845) 897-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009554-1NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Hospital / Medicine Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343692800000",
    "number": "1619967668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 OLD MAIN ST",
            "address_2": "SUITE 204",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125241883",
            "telephone_number": "845-897-4100",
            "fax_number": "845-897-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 OLD MAIN ST",
            "address_2": "SUITE 204",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125241883",
            "telephone_number": "845-897-4100",
            "fax_number": "845-897-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMSKY",
        "first_name": "DAVID",
        "middle_name": "JOSHUA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2012-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "009554-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishkill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.