Steven James Ellman, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3650 Issued in NY

Practice address

140 Riverside Dr
14-A
New York, NY 10024-2605

Phone

(212) 874-7344

Fax

(212) 362-5932

NPI assigned

Apr 17, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 5, 2019 through Nov 5, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629294954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 RIVERSIDE DR",
            "address_2": "14-A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100242605",
            "telephone_number": "212-874-7344",
            "fax_number": "212-362-5932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 RIVERSIDE DR",
            "address_2": "14-A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100242605",
            "telephone_number": "212-874-7344",
            "fax_number": "212-362-5932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLMAN",
        "first_name": "STEVEN",
        "middle_name": "JAMES",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "3650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl Elliston, DABR
• Lauren Noelle Elliston, MD
• Lisa Kim Ellman-Grunther, M.D.
• Carolyn Sandra Ellman, PHD
• Elizabeth Ellman, PSYD
• Tanya Ellman, MD
• Lucy Fe Miraflor Ello
• Naomi Ello, N.P.
• Sharif Ellozy, MD
• Grant Ellsworth, MD

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.