Active NPI
Theodore Tsaousides, PHD
- Psychologist
- New York, NY
National Provider Identifier
1629236781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 017282-1
- Practice address
- 5 E 98TH St
Box 1240B
New York, NY 10029-6501 - Phone
- (212) 241-6547
- NPI assigned
- May 27, 2008
- Last updated
- Nov 11, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 017282-1 | NY | |
| Psychologist | 103T00000X | 017282-1 | NY | Primary |
Addresses
Primary practice location
5 E 98TH St
Box 1240B
New York, NY 10029-6501
Mailing address
5 E 98TH St
Box 1240B
New York, NY 10029-6501
Phone (212) 241-6547
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017282-1 | NY | MD | Clinical Neuropsychologist |
| 017282 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neuropsych Wellness LLC | Clinical Neuropsychologist | Current | 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.
-
- Clinical Neuropsychologist
- Fort Lauderdale, FL
- NPI 1740914159
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257897600000",
"number": "1629236781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 E 98TH ST",
"address_2": "BOX 1240B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100296501",
"telephone_number": "212-241-6547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 E 98TH ST",
"address_2": "BOX 1240B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100296501",
"telephone_number": "212-241-6547"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TSAOUSIDES",
"first_name": "THEODORE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-27",
"last_updated": "2009-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "NY",
"license": "017282-1",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "017282-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.