Individual provider Active NPI

Thomas A. Caffrey, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1669417390
Registry record updated Oct 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
005261-1 Issued in NY
Practice address
1841 Broadway
Suite 702
New York, NY 10023-7603
Phone
(212) 977-3189
Fax
(646) 289-5138
NPI assigned
Jun 17, 2006
Last updated
Oct 4, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 005261-1 NY Primary
Forensic Psychologist 103TF0200X 005261-1 NY

Addresses

Primary practice location

1841 Broadway
Suite 702
New York, NY 10023-7603

Mailing address

1841 Broadway
Suite 702
New York, NY 10023-7603
Phone (212) 977-3189

Other identifiers 3

IdentifierTypeStateIssuer
11558968OtherNYCAQH PROVIDER ID
00910081MedicaidNY
816OtherALCERTIFICATE PROFESSIONAL QUALIFICATION (CPQ) PSYCHOLOGY

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

LicenseStateTypeSpecialty
005261-1NYMDClinical Psychologist
005261NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286150400000",
    "number": "1669417390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1841 BROADWAY",
            "address_2": "SUITE 702",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237603",
            "telephone_number": "212-977-3189",
            "fax_number": "646-289-5138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 BROADWAY",
            "address_2": "SUITE 702",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237603",
            "telephone_number": "212-977-3189",
            "fax_number": "646-289-5138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAFFREY",
        "first_name": "THOMAS",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2010-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "005261-1",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "NY",
            "license": "005261-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "11558968",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00910081",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATE PROFESSIONAL QUALIFICATION (CPQ) PSYCHOLOGY",
            "identifier": "816",
            "state": "AL"
        }
    ],
    "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 Oct 4, 2010; 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.