Individual provider Active NPI

Monique Winnett, PSY.D.

  • Clinical Child & Adolescent Psychologist
  • Syracuse, NY
National Provider Identifier
1649319203
Registry record updated Nov 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
018869 Issued in NY
Practice address
742 James St
Syracuse, NY 13203-2017
Phone
(315) 744-1478
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 018869 NY Primary

Addresses

Primary practice location

742 James St
Syracuse, NY 13203-2017

Mailing address

742 James St
Syracuse, NY 13203-2017

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110718000505 NY Practitioner - Clinical Psychologist 3476721440 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Hospital Health CenterGroup PAC ID 9234043324, 107 clinicians

Practice addresses (Care Compare)

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5111

321 Gifford St
Syracuse, NY 13204-3201
Phone (315) 703-2600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
018869NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Healthcare, PLLC CurrentSince Jun 1, 2011 Accepting new patients
St Josephs Hospital Health Center CurrentSince Jul 1, 2014 Accepting new patients
New York Anesthesiology Medical Specialties, PC CurrentSince Aug 1, 2014 Accepting new patients
New York Anesthesiology Medical Specialties PC CurrentSince Aug 1, 2014 Accepting new patients
St Joseph'S Hospital Health Center Past Accepting new patients

Locations

8289 Loop Rd
Baldwinsville, NY 13027
Phone (315) 452-0300

5719 Widewaters Pkwy
Syracuse, NY 13214
Phone (315) 251-3110

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

742 James St
Syracuse, NY 13203
Phone (315) 703-2700

3300 James St
Ste 100
Syracuse, NY 13206

Organizations & group practices 5

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1649319203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032017",
            "telephone_number": "315-744-1478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINNETT",
        "first_name": "MONIQUE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "018869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.