Active NPI
Anthony Xavier Ullrich
- Peer Specialist
- Amityville, NY
National Provider Identifier
1740087683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- CRPA-7154
- Practice address
- 201 Dixon Ave
Amityville, NY 11701-2994 - Phone
- (516) 724-0308
- NPI assigned
- Feb 27, 2025
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | CRPA-7154 | NY | Primary |
Addresses
Primary practice location
201 Dixon Ave
Amityville, NY 11701-2994
Mailing address
201 Dixon Ave
Amityville, NY 11701-2994
Phone (516) 724-0308
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CRPA-P-7856 | NY | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786579200000",
"number": "1740087683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 DIXON AVE",
"city": "AMITYVILLE",
"state": "NY",
"postal_code": "117012994",
"telephone_number": "516-724-0308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 DIXON AVE",
"city": "AMITYVILLE",
"state": "NY",
"postal_code": "117012994",
"telephone_number": "516-724-0308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ULLRICH",
"first_name": "ANTHONY",
"middle_name": "XAVIER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-02-27",
"last_updated": "2026-08-13",
"certification_date": "2026-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "NY",
"license": "CRPA-7154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Amityville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.