Individual provider Active NPI

Sharon C. Leon, PH.D.

  • Clinical Psychologist
  • Commack, NY
National Provider Identifier
1760437255
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
016482-1 Issued in NY
Practice address
145 Commack Rd
Suite 13
Commack, NY 11725
Phone
(631) 858-0060
Fax
(631) 858-0060
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 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 016482-1 NY Primary

Addresses

Primary practice location

145 Commack Rd
Suite 13
Commack, NY 11725

Mailing address

145 Commack Road
Suite 13
Commack, NY 11725
Phone (631) 858-0060

Other identifiers 1

IdentifierTypeStateIssuer
02750067MedicaidNY

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
I20060614000278 NY Practitioner - Clinical Psychologist 5193737013 Practice locations: Commack, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

145 Commack Rd
Suite 13
Commack, NY 11725-3438
Phone (631) 858-0060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016482-1NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Knapp Street Psychiatry, PC Clinical PastSince Feb 2, 2020 Accepting new patients

Networks

  • Healthfirst Medicare Network H9678

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1760437255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 COMMACK ROAD",
            "address_2": "SUITE 13",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "11725",
            "telephone_number": "631-858-0060",
            "fax_number": "631-858-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 COMMACK RD",
            "address_2": "SUITE 13",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "11725",
            "telephone_number": "631-858-0060",
            "fax_number": "631-858-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON",
        "first_name": "SHARON",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016482-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02750067",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.