Individual provider Active NPI

Samantha Rogowicz, PHD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1710465844
Registry record updated Jan 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
022271 Issued in NY
Practice address
928 Broadway Ste 304
New York, NY 10010-8154
Phone
(347) 620-1617
NPI assigned
Jul 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2023

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 022271 NY Primary

Addresses

Primary practice location

928 Broadway Ste 304
New York, NY 10010-8154

Mailing address

928 Broadway Ste 304
New York, NY 10010-8154
Phone (347) 620-1617

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 16, 2019 through Jul 16, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
022271NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Purple Key Psychology, PLLC Current Accepting new patients

Locations

928 Broadway
Ste 304
New York, NY 10010
Phone (212) 375-9802

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": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674259200000",
    "number": "1710465844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 BROADWAY STE 304",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100108154",
            "telephone_number": "347-620-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 BROADWAY STE 304",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100108154",
            "telephone_number": "347-620-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGOWICZ",
        "first_name": "SAMANTHA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2023-01-21",
        "certification_date": "2023-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "022271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.