Individual provider Active NPI

Rodrigo Sebastian Munoz, PSYD.

  • Clinical Psychologist
  • Mount Vernon, NY
National Provider Identifier
1720960073
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
27412 Issued in NY
Practice address
3 S 6TH Ave
Mount Vernon, NY 10550-3197
Phone
(914) 361-7238
Fax
(914) 668-0164
NPI assigned
Jul 25, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810009198 VA
Clinical Psychologist 103TC0700X 40944 TX
Clinical Psychologist 103TC0700X PSY.0006962 CO
Clinical Psychologist 103TC0700X B1-0011541 DE
Clinical Psychologist 103TC0700X 5452-57 WI
Clinical Psychologist 103TC0700X 27412 NY Primary

Addresses

Primary practice location

3 S 6TH Ave
Mount Vernon, NY 10550-3197

Mailing address

603 Homestead Ave
Peekskill, NY 10566-5409
Phone (786) 728-6009

Other practice location 1

1400 Main St Ste 101
Louisville, CO 80027-3046
Phone (720) 684-9845

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
I20251125001334 NY Practitioner - Clinical Psychologist 1355833526

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2261 Market St
San Francisco, CA 94114-1612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
B1-0011541DEMDClinical Psychologist
27412NYMDClinical Psychologist
5452-57WIMDClinical Psychologist
40944TXMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical, P.C. CurrentSince Nov 1, 2025 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

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": "1753401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1720960073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 HOMESTEAD AVE",
            "city": "PEEKSKILL",
            "state": "NY",
            "postal_code": "105665409",
            "telephone_number": "786-728-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 S 6TH AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105503197",
            "telephone_number": "914-361-7238",
            "fax_number": "914-668-0164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Main St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "CO",
            "postal_code": "800273046",
            "country_code": "US",
            "telephone_number": "720-684-9845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNOZ",
        "first_name": "RODRIGO",
        "middle_name": "SEBASTIAN",
        "name_prefix": "Dr.",
        "credential": "PSYD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-25",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810009198",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "40944",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0006962",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DE",
            "license": "B1-0011541",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "5452-57",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "27412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

Verify at the official NPI Registry.