Individual provider Active NPI

Susan Starr Krasner, PH.D.

  • Clinical Psychologist
  • East Amherst, NY
National Provider Identifier
1770675167
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
010762 Issued in NY
Practice address
6507 Transit Rd
Ste B
East Amherst, NY 14051-1427
Phone
(716) 204-0100
Fax
(716) 204-2761
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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 010762 NY Primary

Addresses

Primary practice location

6507 Transit Rd
Ste B
East Amherst, NY 14051-1427

Mailing address

6507 Transit Rd
Ste B
East Amherst, NY 14051-1427
Phone (716) 204-0100

Other identifiers 3

IdentifierTypeStateIssuer
000511230001OtherNYBC/BS WNY
00020351401OtherNYUNIVERA
6190235OtherNYINDEPENDENT HEALTH

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
I20070418000351 NY Practitioner - Clinical Psychologist 7315042496 Practice locations: Williamsville, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6507 Transit Rd
East Amherst, NY 14051-1427

8616 Main St
Suite 2
Williamsville, NY 14221-7461
Phone 71620401002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010762NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Behavioral Psychology, PC PastSince Aug 23, 2015 Accepting new patients
Mary Jo Penizotto, PHD PastSince Mar 9, 2020 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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1770675167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6507 TRANSIT RD",
            "address_2": "STE B",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140511427",
            "telephone_number": "716-204-0100",
            "fax_number": "716-204-2761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6507 TRANSIT RD",
            "address_2": "STE B",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140511427",
            "telephone_number": "716-204-0100",
            "fax_number": "716-204-2761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASNER",
        "first_name": "SUSAN",
        "middle_name": "STARR",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "010762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS WNY",
            "identifier": "000511230001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00020351401",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "6190235",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Amherst, NY

Sources for this page

Verify at the official NPI Registry.