Individual provider Active NPI

Joseph Stephen Zucker, PHD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1669547220
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4133 Issued in NY
Practice address
1449 Lexington Ave
3W
New York, NY 10128-2543
Phone
(212) 628-1330
Fax
(212) 722-8513
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 4133 NY Primary

Addresses

Primary practice location

1449 Lexington Ave
3W
New York, NY 10128-2543

Mailing address

1449 Lexington Ave
Apt 3W
New York, NY 10128-2543
Phone (212) 628-1330

Other identifiers 1

IdentifierTypeStateIssuer
01714850MedicaidNY

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
I20070519000064 NY Practitioner - Clinical Psychologist 1951408350 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1449 Lexington Ave
New York, NY 10128-2543
Phone (212) 628-1330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4133NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1669547220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1449 LEXINGTON AVE",
            "address_2": "APT 3W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101282543",
            "telephone_number": "212-628-1330",
            "fax_number": "212-722-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1449 LEXINGTON AVE",
            "address_2": "3W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101282543",
            "telephone_number": "212-628-1330",
            "fax_number": "212-722-8513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUCKER",
        "first_name": "JOSEPH",
        "middle_name": "STEPHEN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "4133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01714850",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.