Individual provider Active NPI

Ilene D Jurmann, PH.D

  • Clinical Psychologist
  • Amityville, NY
National Provider Identifier
1700986288
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
013920 Issued in NY
Practice address
5 Dowsing PL
Amityville, NY 11701-3719
Phone
(631) 598-0147
Fax
(631) 598-4823
NPI assigned
Sep 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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 013920 NY Primary

Addresses

Primary practice location

5 Dowsing PL
Amityville, NY 11701-3719

Mailing address

5 Dowsing PL
Amityville, NY 11701-3719
Phone (631) 598-0147

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
I20050916000586 NY Practitioner - Clinical Psychologist 6204869514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

21 Redwood LN
Smithtown, NY 11787-2718
Phone (516) 641-4961

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ilene Jurmann, PH.D., Psychologist, P.C. Clinical CurrentSince Jun 23, 2010 Accepting new patients

Locations

5 Dowsing Pl
Amityville, NY 11701
Phone (631) 598-0147

21 Redwood Ln
Smithtown, NY 11787
Phone (631) 360-3330

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1700986288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 DOWSING PL",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117013719",
            "telephone_number": "631-598-0147",
            "fax_number": "631-598-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 DOWSING PL",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117013719",
            "telephone_number": "631-598-0147",
            "fax_number": "631-598-4823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURMANN",
        "first_name": "ILENE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-24",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "013920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

Verify at the official NPI Registry.