Active NPI
Vivian Mougios, PHD
- Clinical Neuropsychologist
- New York, NY
National Provider Identifier
1730766288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 015916
- Practice address
- 127 W 96TH St.
Suite 1B
New York, NY 10025 - Phone
- (212) 749-3932
- Fax
- (646) 201-4401
- NPI assigned
- Mar 29, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 015916 | NY | Primary |
Addresses
Primary practice location
127 W 96TH St.
Suite 1B
New York, NY 10025
Mailing address
127 W 96TH St.
Suite 1B
New York, NY 10025
Phone (212) 749-3932
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015916 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616976000000",
"number": "1730766288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 W 96TH ST.",
"address_2": "SUITE 1B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10025",
"telephone_number": "212-749-3932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 W 96TH ST.",
"address_2": "SUITE 1B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10025",
"telephone_number": "212-749-3932",
"fax_number": "646-201-4401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUGIOS",
"first_name": "VIVIAN",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-29",
"last_updated": "2021-03-29",
"certification_date": "2021-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Clinical Neuropsychologist",
"state": "NY",
"license": "015916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.