Individual provider Active NPI

Simona Gabriela Amalathas, M.D.

  • Psychiatry Physician
  • Poughkeepsie, NY
National Provider Identifier
1821199498
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
212866 Issued in NY
Practice address
22 Ibm Rd Ste 104a
Poughkeepsie, NY 12601-5461
Phone
(845) 463-4044
Fax
(845) 463-0945
NPI assigned
Sep 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 212866 NY Primary

Addresses

Primary practice location

22 Ibm Rd Ste 104a
Poughkeepsie, NY 12601-5461

Mailing address

22 Ibm Rd Ste 104a
Poughkeepsie, NY 12601-5461
Phone (845) 463-4044

Other identifiers 4

IdentifierTypeStateIssuer
207168OtherNYMVP
P-2850729OtherOXFORD
3186053OtherGHI BMP
10040052OtherCDPHP

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031202000078 NY Practitioner - Psychiatry 1052216298 Practice locations: Poughkeepsie, NY

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

22 Ibm Rd
Poughkeepsie, NY 12601-5461
Phone (845) 463-4044

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vassar-Warner Home Past Accepting new patients
Hollander Psychological Consulting PC 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, 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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821199498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 IBM RD STE 104A",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126015461",
            "telephone_number": "845-463-4044",
            "fax_number": "845-463-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 IBM RD STE 104A",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126015461",
            "telephone_number": "845-463-4044",
            "fax_number": "845-463-0945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMALATHAS",
        "first_name": "SIMONA",
        "middle_name": "GABRIELA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "212866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "207168",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P-2850729",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI BMP",
            "identifier": "3186053",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10040052",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.