Individual provider Active NPI

Amy Sugarman, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1821270091
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
015404-1 Issued in NY
Practice address
303 5TH Ave
Suite 606
New York, NY 10016-6601
Phone
(212) 414-5156
NPI assigned
Nov 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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 015404-1 NY Primary

Addresses

Primary practice location

303 5TH Ave
Suite 606
New York, NY 10016-6601

Mailing address

65 Park Ave
Port Washington, NY 11050-4033
Phone (212) 414-5156

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Nov 2, 2020 through Nov 2, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
015404-1NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1821270091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 PARK AVE",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110504033",
            "telephone_number": "212-414-5156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 5TH AVE",
            "address_2": "SUITE 606",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166601",
            "telephone_number": "212-414-5156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUGARMAN",
        "first_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-29",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "015404-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.