Individual provider Active NPI

Richard Jason Fost, PH.D.

  • Clinical Psychologist
  • Poughkeepsie, NY
National Provider Identifier
1780624197
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
012365 Issued in NY
Practice address
12 Davis Ave
Suite 2N
Poughkeepsie, NY 12603-2408
Phone
(845) 452-4949
Fax
(845) 452-8510
NPI assigned
Jun 7, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 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 012365 NY Primary

Addresses

Primary practice location

12 Davis Ave
Suite 2N
Poughkeepsie, NY 12603-2408

Mailing address

134 Cramer Rd
Poughkeepsie, NY 12603-6325
Phone (845) 452-4949

Other identifiers 5

IdentifierTypeStateIssuer
192792OtherNYMHN PROVIDER ID
243298OtherNYVALUEOPTIONS PROVIDER ID
946918OtherNYMVP ID# (SOLE PROPRIETOR)
01578578MedicaidNY
P1017060OtherNYOXFORD PROVIDER ID

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
I20040322000068 NY Practitioner - Clinical Psychologist 0840181848 Practice locations: Poughkeepsie, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12 Davis Ave
2N
Poughkeepsie, NY 12603-2408
Phone (845) 452-4949

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012365NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1780624197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 CRAMER RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126036325",
            "telephone_number": "845-452-4949",
            "fax_number": "845-452-8510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 DAVIS AVE",
            "address_2": "SUITE 2N",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126032408",
            "telephone_number": "845-452-4949",
            "fax_number": "845-452-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOST",
        "first_name": "RICHARD",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "012365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN PROVIDER ID",
            "identifier": "192792",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS PROVIDER ID",
            "identifier": "243298",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP ID# (SOLE PROPRIETOR)",
            "identifier": "946918",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01578578",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PROVIDER ID",
            "identifier": "P1017060",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.