Michael Ivanov, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

020355 Issued in NY

Practice address

222 E 44TH St Apt 19K
New York, NY 10017-4453

Phone

(212) 602-1722

NPI assigned

Dec 23, 2006

Last updated

Aug 12, 2025By 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

Other identifiers 2

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

Specialty

Clinical Psychologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Nyc Psychological Services, PLLC

  • Clinical Psychologist
  • New York, NY
  • NPI 1124431002
  Medicare reassignment Authorized official
• Hospitalist Healthcare Services PLLC

  • Internal Medicine Physician
  • White Plains, NY
  • NPI 1275962011
  NPD (past)

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

{
    "created_epoch": "1166832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1639234313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E 44TH ST APT 19K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100174453",
            "telephone_number": "212-602-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E 44TH ST APT 19K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100174453",
            "telephone_number": "212-602-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVANOV",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-23",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "020355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03809318",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BIS",
            "identifier": "5926",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elena A, Ivanina, D.O.
• Chastety Ivaniuk, LCSW, LMSW, CASAC
• Alexander Cyril Ivanov, MD
• Artem Ivanov
• Iliyan Stoyanov Ivanov, M.D.
• Nikolay A Ivanov, MD
• Vera Ivanova
• Yordanka K Ivanova, D.M.D
• Irina Ivanson, LMSW
• Marie-Michelle Ivantechenko

• 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 Aug 12, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.