Individual provider Active NPI

Tim A Ahles, PHD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1770660656
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
016629 Issued in NY
Practice address
1275 York Ave
New York, NY 10021-6007
Phone
(646) 227-3275
NPI assigned
Oct 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 016629 NY Primary

Addresses

Primary practice location

1275 York Ave
New York, NY 10021-6007

Mailing address

633 3Rd Ave
Box 3
New York, NY 10017-6706

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
I20060504000996 NY Practitioner - Clinical Psychologist 9234154717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorial Psychiatry GroupGroup PAC ID 2062301476, 50 clinicians

Practice addresses (Care Compare)

205 E 64TH St
New York, NY 10065-6635
Phone (646) 449-1000

Merit-based Incentive Payment System (MIPS)

Final score
73.61 of 100Reported as group
Quality
70.88
Improvement activities
40
Cost
46.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
385NHMDMental Health Counselor

Practice roles (1 of 5)

OrganizationSpecialtyStatusNew patients
Memorial Psychiatry Group Clinical CurrentSince Mar 31, 2006 Accepting new patients

Locations

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

205 E 64th St
New York, NY 10065
Phone (212) 639-3127

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • 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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770660656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 3RD AVE",
            "address_2": "BOX 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100216007",
            "telephone_number": "646-227-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHLES",
        "first_name": "TIM",
        "middle_name": "A",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.