Peter S Kanaris, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

006658 Issued in NY

Practice address

496 Smithtown Byp
#304
Smithtown, NY 11787-5005

Phone

(631) 979-2640

Fax

(631) 979-2684

NPI assigned

Nov 30, 2005

Last updated

Dec 17, 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 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Kanaris Psychological Services PC

  • Psychologist
  • Smithtown, NY
  • NPI 1144205105
  Authorized official Same address or phone

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1649254970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 SMITHTOWN BYP",
            "address_2": "#304",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875005",
            "telephone_number": "631-979-2640",
            "fax_number": "631-979-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 SMITHTOWN BYP",
            "address_2": "#304",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875005",
            "telephone_number": "631-979-2640",
            "fax_number": "631-979-2684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANARIS",
        "first_name": "PETER",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "006658",
            "primary": true
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NY",
            "license": "006658",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NY",
            "license": "006658",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "NY",
            "license": "006658",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "NY",
            "license": "006658",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00600091",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alan T. Kaell, M.D.
• Vasilios Kalonaros, M.D.
• Kalter Physical Medicine & Rehabilitation PC
• Michael Kampourakis, DDS
• Kanaris Psychological Services PC
• Stacy Kanen-Green, LCSW
• Polly Kanganis, M.D.
• Norman J Kanter, PHD
• Manisha Kanumuri, MD
• Kanwar Iqbal Singh Gill, MD. PC

• Clinical Psychologist in Smithtown, NY
• Providers in Smithtown, 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 Dec 17, 2007; 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.