Individual provider Active NPI

William Hernandez, PHD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1801066725
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0147261 Issued in NY
Practice address
1225 Park Avenue
Suite # 15C
New York, NY 10128
Phone
(212) 332-0770
Fax
(212) 332-0770
NPI assigned
Mar 6, 2008
Last updated
Nov 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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 0147261 NY Primary

Addresses

Primary practice location

1225 Park Avenue
Suite # 15C
New York, NY 10128

Mailing address

16 Upland Rd
New Rochelle, NY 10804
Phone (212) 332-0770

Other practice location 1

156 W 56th St Ste 1804
New York, NY 10019-3878
Phone (212) 851-8100

Other identifiers 1

IdentifierTypeStateIssuer
03514894MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0147261NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1801066725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 UPLAND RD",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "10804",
            "telephone_number": "212-332-0770",
            "fax_number": "212-332-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 PARK AVENUE",
            "address_2": "SUITE # 15C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10128",
            "telephone_number": "212-332-0770",
            "fax_number": "212-332-0770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "156 W 56th St Ste 1804",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100193878",
            "country_code": "US",
            "telephone_number": "212-851-8100",
            "fax_number": "888-977-2547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-06",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "0147261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03514894",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.