Active NPI
Susan Sara Vogel, PH.D.
- Clinical Psychologist
- Brooklyn, NY
National Provider Identifier
1760791669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 011034-1
- Practice address
- 250 Baltic St
Brooklyn, NY 11201-6401 - Phone
- (718) 855-3131
- NPI assigned
- Sep 27, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 011034-1 | NY | Primary |
Addresses
Primary practice location
250 Baltic St
Brooklyn, NY 11201-6401
Mailing address
250 Baltic St
Brooklyn, NY 11201-6401
Phone (718) 855-3131
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241003000444 | NY | Order and Referring Only - Clinical Psychologist | 9537690466 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011034-1 | NY | MD | Speech-Language Pathologist |
| 011034 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Beach Psychiatric Center | Past | Accepting new patients | |
| Baltic Street Clinic | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Brooklyn, NY
- NPI 1558670414
-
- Community/Behavioral Health Agency
- Brooklyn, NY
- NPI 1700195450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285545600000",
"number": "1760791669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 BALTIC ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112016401",
"telephone_number": "718-855-3131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 BALTIC ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112016401",
"telephone_number": "718-855-3131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VOGEL",
"first_name": "SUSAN",
"middle_name": "SARA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-27",
"last_updated": "2010-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "011034-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.