Active NPI
Tal Sommer
- Clinical Psychologist
- Forest Hills, NY
National Provider Identifier
1790088946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 022502-1
- Practice address
- 104 70 Queens Boulevard
Suite 200
Forest Hills, NY 11375-3694 - Phone
- (718) 275-6010
- Fax
- (718) 275-6062
- NPI assigned
- Dec 9, 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 | 022502-1 | NY | Primary |
Addresses
Primary practice location
104 70 Queens Boulevard
Suite 200
Forest Hills, NY 11375-3694
Mailing address
104 70 Queens Boulevard
Suite 200
Forest Hills, NY 11375-3694
Phone (718) 275-6010
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022502-1 | NY | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bleuler Psychotherapy Center, Inc. | Current | Accepting new patients |
Locations
10470 Queens Blvd
Ste 200
Forest Hills, NY 11375
Phone (866) 404-6913
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/bleulerpc/r4/
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Forest Hills, NY
- NPI 1801949706
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517788800000",
"number": "1790088946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 70 QUEENS BOULEVARD",
"address_2": "SUITE 200",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113753694",
"telephone_number": "718-275-6010",
"fax_number": "718-275-6062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 70 QUEENS BOULEVARD",
"address_2": "SUITE 200",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113753694",
"telephone_number": "718-275-6010",
"fax_number": "718-275-6062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOMMER",
"first_name": "TAL",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-09",
"last_updated": "2018-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "022502-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; 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.