Mary Ann Moore, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

011128-1 Issued in NY

Practice address

679 Main St
Johnson City, NY 13790-1716

Phone

(607) 237-0645

NPI assigned

Sep 7, 2020

Last updated

Sep 7, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Mary Ann Corrigan Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Che Senior Psychological Services, PC

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  • NPI 1023078219
  Medicare reassignment NPD
• Knapp Street Psychiatry, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1043248776
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599436800000",
    "number": "1770197766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 OCONNELL RD",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138506001",
            "telephone_number": "607-239-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "679 MAIN ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901716",
            "telephone_number": "607-237-0645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 OConnell Rd",
            "address_purpose": "LOCATION",
            "city": "Vestal",
            "state": "NY",
            "postal_code": "138506001",
            "country_code": "US",
            "telephone_number": "607-239-8063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARY ANN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-07",
        "last_updated": "2020-09-07",
        "certification_date": "2020-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "011128-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY ANN",
            "last_name": "CORRIGAN",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Margaret Susan Monborne, OTR
• Jennifer Kathryn Monnin, PHARMD
• Julio Damian Montejo Jr., MD, MHS
• Vincent Montone, MD
• Emily Nicole Moore, OTR/L
• Paula A Moore, CNM
• Matthew James Moquin, RPH
• Chloe Mae Morgan
• William Morgan
• Sharon L Moss, MSW,LCSW

• Clinical Psychologist in Johnson City, NY
• Providers in Johnson City, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2020; 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.

Verify at the official NPI Registry.