Active NPI
Andrew Mark Zaitsoff, PH.D.
- Psychologist
- West Lafayette, IN
National Provider Identifier
1679070924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 20043139A
- Practice address
- 601 Stadium Mall Dr
West Lafayette, IN 47907-2052 - Phone
- (765) 494-6995
- NPI assigned
- Apr 11, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 20043139A | IN | Primary |
Addresses
Primary practice location
601 Stadium Mall Dr
West Lafayette, IN 47907-2052
Mailing address
601 Stadium Mall Dr
West Lafayette, IN 47907-2052
Phone (765) 494-6995
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20043139A | IN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523404800000",
"number": "1679070924",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 STADIUM MALL DR",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479072052",
"telephone_number": "765-494-6995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 STADIUM MALL DR",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479072052",
"telephone_number": "765-494-6995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZAITSOFF",
"first_name": "ANDREW",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-11",
"last_updated": "2018-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IN",
"license": "20043139A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.