Active NPI
Jane Davidson, PSY.D.
- Psychologist
- New York, NY
National Provider Identifier
1811295280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 009655-1
- Practice address
- 19 W 34TH St PH
New York, NY 10001-3006 - Phone
- (917) 991-4065
- NPI assigned
- Mar 8, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 009655-1 | NY | Primary |
Addresses
Primary practice location
19 W 34TH St PH
New York, NY 10001-3006
Mailing address
19 W 34TH St PH
New York, NY 10001-3006
Phone (917) 991-4065
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170426001294 | NY | Practitioner - Clinical Psychologist | 9032496294 | Practice locations: New York, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
305 E 24TH St
Apt 6P
New York, NY 10010-4058
Phone (917) 991-4065
305 E 24TH St Apt
6P
New York, NY 10010-4058
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009655-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320624000000",
"number": "1811295280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 W 34TH ST PH",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100013006",
"telephone_number": "917-991-4065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 W 34TH ST PH",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100013006",
"telephone_number": "917-991-4065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "JANE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-08",
"last_updated": "2011-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "009655-1",
"primary": true
}
],
"identifiers": [],
"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 7, 2011; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.