Active NPI
Charles L. Ihlenfeld II, M.D.
- Psychiatry Physician
- Shelter Island Heights, NY
National Provider Identifier
1699773705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 092919
- Practice address
- 14 South Menantic Road
Shelter Island Heights, NY 11965 - Phone
- (631) 278-5127
- Fax
- (631) 749-3079
- NPI assigned
- Jul 12, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 092919 | NY | Primary |
Addresses
Primary practice location
14 South Menantic Road
Shelter Island Heights, NY 11965
Mailing address
PO Box 576
Shelter Island Heights, NY 11965-0576
Phone (631) 278-5127
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M00150376 Y0608 | Medicaid | NY |
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: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060419000412 | NY | Practitioner - Psychiatry | 0648289694 | Practice locations: Shelter Is HTS, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378339200000",
"number": "1699773705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 576",
"city": "SHELTER ISLAND HEIGHTS",
"state": "NY",
"postal_code": "119650576",
"telephone_number": "631-278-5127",
"fax_number": "631-749-3079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 SOUTH MENANTIC ROAD",
"city": "SHELTER ISLAND HEIGHTS",
"state": "NY",
"postal_code": "11965",
"telephone_number": "631-278-5127",
"fax_number": "631-749-3079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IHLENFELD",
"first_name": "CHARLES",
"middle_name": "L.",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-12",
"last_updated": "2013-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "092919",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "M00150376 Y0608",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shelter Island Heights, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.