Individual provider Active NPI

James Colasurdo, PSY.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1831149830
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
015965 Issued in NY
Practice address
156 W 56TH St Ste 1804
New York, NY 10019-3878
Phone
(212) 851-8100
Fax
(888) 977-2547
NPI assigned
May 11, 2006
Last updated
May 7, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2018

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 015965 NY Primary

Addresses

Primary practice location

156 W 56TH St Ste 1804
New York, NY 10019-3878

Mailing address

156 W 56TH St Ste 1804
New York, NY 10019-3878
Phone (212) 851-8100

Other identifiers 1

IdentifierTypeStateIssuer
02569542MedicaidNY

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
I20041006001426 NY Practitioner - Clinical Psychologist 3577522416 Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

235 Garfield PL
Brooklyn, NY 11215-2208
Phone (516) 938-0362

44 Court St
Suite 910
Brooklyn, NY 11201-4413
Phone (516) 938-0362

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015965NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aspyr Therapy Services SLP PLLC Past Accepting new patients
Park Avenue Medical Associates, P.C. PastSince Dec 4, 1999 Accepting new patients
RS Neuro Medical, P.C. Past Accepting new patients

Organizations & group practices 3

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1831149830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 W 56TH ST STE 1804",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193878",
            "telephone_number": "212-851-8100",
            "fax_number": "888-977-2547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 W 56TH ST STE 1804",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100193878",
            "telephone_number": "212-851-8100",
            "fax_number": "888-977-2547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLASURDO",
        "first_name": "JAMES",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "015965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02569542",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.