Individual provider Active NPI

Taher Zandi, PHD

  • Clinical Psychologist
  • Plattsburgh, NY
National Provider Identifier
1811937204
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
015955 Issued in NY
Practice address
110 W Bay PLZ
Plattsburgh, NY 12901-1785
Phone
(518) 561-3707
Fax
(518) 825-3707
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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 015955 NY Primary

Addresses

Primary practice location

110 W Bay PLZ
Plattsburgh, NY 12901-1785

Mailing address

110 W Bay PLZ
Plattsburgh, NY 12901-1785
Phone (518) 561-3707

Other identifiers 1

IdentifierTypeStateIssuer
02703542MedicaidNY

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
I20040915000861 NY Practitioner - Clinical Psychologist 6800863184 Practice locations: Plattsburgh, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Oklahoma College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

96 Court St
Plattsburgh, NY 12901-2733
Phone (518) 852-3707

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015955NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Headwaters Health Network Past Accepting new patients
Hudson Headwaters Health Network Past Accepting new patients

Organizations & group practices 2

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.

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": "1386720000000",
    "number": "1811937204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W BAY PLZ",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011785",
            "telephone_number": "518-561-3707",
            "fax_number": "518-825-3707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W BAY PLZ",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011785",
            "telephone_number": "518-561-3707",
            "fax_number": "518-825-3707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANDI",
        "first_name": "TAHER",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "015955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02703542",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

Verify at the official NPI Registry.