Individual provider Active NPI

Jessica Katherine Masty, PH.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1841524899
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
68-021189 Issued in NY
Practice address
501 Fifth Avenue
Suite 1709
New York, NY 10017-6129
Phone
(516) 661-4603
Fax
(914) 423-9434
NPI assigned
Sep 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 68-021189 NY
Student in an Organized Health Care Education/Training Program 390200000X
Psychologist 103T00000X 68-021189 NY Primary

Addresses

Primary practice location

501 Fifth Avenue
Suite 1709
New York, NY 10017-6129

Mailing address

501 Fifth Avenue
Suite 1709
New York, NY 10017-6129
Phone (516) 661-4603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68-021189NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1841524899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 FIFTH AVENUE",
            "address_2": "SUITE 1709",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176129",
            "telephone_number": "516-661-4603",
            "fax_number": "914-423-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 FIFTH AVENUE",
            "address_2": "SUITE 1709",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176129",
            "telephone_number": "516-661-4603",
            "fax_number": "914-423-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTY",
        "first_name": "JESSICA",
        "middle_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "68-021189",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "68-021189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.