Active NPI
Elizabeth Hegeman, PHD
- Clinical Psychologist
- New York, NY
National Provider Identifier
1669455416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 004431
- Practice address
- 490 W End Ave
Suite Le
New York, NY 10024-4329 - Phone
- (212) 877-3007
- NPI assigned
- Nov 25, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 004431 | NY | Primary |
Addresses
Primary practice location
490 W End Ave
Suite Le
New York, NY 10024-4329
Mailing address
100 Riverside Dr
10C
New York, NY 10024-4822
Phone (212) 874-5610
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111123000300 | NY | Practitioner - Clinical Psychologist | 9931373230 | Practice locations: New York, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1974
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
41 W 72ND St
Apt 10H
New York, NY 10023-3468
Phone (917) 854-0665
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004431 | NY | MD | Veterinarian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281484800000",
"number": "1669455416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 RIVERSIDE DR",
"address_2": "10C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100244822",
"telephone_number": "212-874-5610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "490 W END AVE",
"address_2": "SUITE LE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100244329",
"telephone_number": "212-877-3007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEGEMAN",
"first_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-11-25",
"last_updated": "2010-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "004431",
"primary": true
}
],
"identifiers": [],
"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 Aug 11, 2010; 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.