Active NPI
Angelica Maria Perez, PHD
- Clinical Psychologist
- Nyack, NY
National Provider Identifier
1760540520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 014014-1
- Practice address
- 99 Main St
Nyack, NY 10960-3109 - Phone
- (917) 817-2869
- Fax
- (646) 219-8905
- NPI assigned
- Dec 5, 2006
- Last updated
- Sep 10, 2008
- 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 Psychologist | 103TC0700X | 014014-1 | NY | Primary |
Addresses
Primary practice location
99 Main St
Nyack, NY 10960-3109
Mailing address
908 Ashland St
Valley Cottage, NY 10989-2613
Phone (917) 817-2869
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02316127 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014014-1 | NY | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nyumc Aging Center Associates | Past | Accepting new patients | |
| New York University Medical Center | Past | Accepting new patients | |
| New York University | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba NYUMC Behavior Health Program
- Psychiatry Physician
- New York, NY
- NPI 1235129800
-
dba NYU Faculty Group Practice
- Cardiovascular Disease Physician
- Boynton Beach, FL
- NPI 1285826438
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221004800000",
"number": "1760540520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "908 ASHLAND ST",
"city": "VALLEY COTTAGE",
"state": "NY",
"postal_code": "109892613",
"telephone_number": "917-817-2869",
"fax_number": "646-219-8905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 MAIN ST",
"city": "NYACK",
"state": "NY",
"postal_code": "109603109",
"telephone_number": "917-817-2869",
"fax_number": "646-219-8905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "ANGELICA",
"middle_name": "MARIA",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-05",
"last_updated": "2008-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "014014-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02316127",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nyack, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.