Individual provider Active NPI

Anna Trudeau Hickner, PSYD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1811390305
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
020959 Issued in NY
Practice address
1111 Amsterdam Ave
Clark 6TH Floor
New York, NY 10025-1716
Phone
(212) 523-6500
Fax
(212) 523-5677
NPI assigned
Sep 29, 2014
Last updated
Apr 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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 020959 NY Primary

Addresses

Primary practice location

1111 Amsterdam Ave
Clark 6TH Floor
New York, NY 10025-1716

Mailing address

1111 Amsterdam Ave
Clark 6TH Floor
New York, NY 10025-1716
Phone (212) 523-6500

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
I20160610000742 NY Practitioner - Clinical Psychologist 3971893579 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, shared by 32 NPIs, 2,809 clinicians

Practice addresses (Care Compare)

55 E 34TH St
New York, NY 10016-4337
Phone (212) 252-6131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
020959NYMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 10, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

1111 Amsterdam Ave
Fl 6
New York, NY 10025

1425 Madison Ave
New York, NY 10029
Phone (212) 824-8150

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

55 E 34th St
New York, NY 10016
Phone (212) 252-6131

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1411948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1811390305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "address_2": "CLARK 6TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251716",
            "telephone_number": "212-523-6500",
            "fax_number": "212-523-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "address_2": "CLARK 6TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251716",
            "telephone_number": "212-523-6500",
            "fax_number": "212-523-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKNER",
        "first_name": "ANNA",
        "middle_name": "TRUDEAU",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-29",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "020959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.