Individual provider Active NPI

Virginia Kelly Arlt Mutch, PHD

  • Psychologist
  • New York, NY
National Provider Identifier
1679915169
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
240 E 69TH St
New York, NY 10021-5705
Phone
(914) 649-2069
NPI assigned
Jul 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychologist 103T00000X Primary

Addresses

Primary practice location

240 E 69TH St
New York, NY 10021-5705

Mailing address

240 E 69TH St
New York, NY 10021-5705

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
I20191018001103 NY Practitioner - Clinical Psychologist 7911238134 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

156 William St
New York, NY 10038-2609
Phone (646) 962-6647

425 E 61St St
New York, NY 10065-8722
Phone (646) 962-7378

Hospital & facility affiliations

  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Feb 5, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Sep 13, 2019 Accepting new patients
Weill Medical College of Cornell Psychologist CurrentSince Feb 5, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Sep 13, 2019 Accepting new patients

Locations

2058 Jerome Ave
Bronx, NY 10453
Phone (917) 564-8731

111 E 210th St
Bronx, NY 10467

156 William St
New York, NY 10038
Phone (646) 962-4679

240 E 69th St
New York, NY 10021
Phone (212) 472-1717

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1679915169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 E 69TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 E 69TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215705",
            "telephone_number": "914-649-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTCH",
        "first_name": "VIRGINIA",
        "middle_name": "KELLY ARLT",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-24",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.