Individual provider Active NPI

Nancy Ellen Dib

  • Psychologist
  • Kingston, NY
National Provider Identifier
1841453941
Registry record updated Jul 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
139 Cornell St
Kingston, NY 12401-3633
Phone
(845) 338-1234
Fax
(845) 338-6284
NPI assigned
Jul 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

139 Cornell St
Kingston, NY 12401-3633

Mailing address

139 Cornell St
Kingston, NY 12401-3633
Phone (845) 338-1234

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
I20160307001597 NY Practitioner - Clinical Psychologist 5890005953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nysarc, Inc Ulster, Greene, Putnam Counties ChapterGroup PAC ID 2466543764, 10 clinicians

Practice addresses (Care Compare)

139 Cornell St
Kingston, NY 12401-3633
Phone (845) 331-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nysarc Inc. Ulster, Greene, Putnam Counties Chapter CurrentSince Jan 15, 2016 Accepting new patients
Hudson Valley Health Specialties, Inc PastSince Jan 15, 2016 Accepting new patients

Locations

139 Cornell St
Kingston, NY 12401
Phone (845) 331-4300

471 Albany Ave
Kingston, NY 12401
Phone (845) 331-4300

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": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215475200000",
    "number": "1841453941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 CORNELL ST",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013633",
            "telephone_number": "845-338-1234",
            "fax_number": "845-338-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 CORNELL ST",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013633",
            "telephone_number": "845-338-1234",
            "fax_number": "845-338-6284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIB",
        "first_name": "NANCY",
        "middle_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2008-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.