Individual provider Active NPI

Melinda Cornwell, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1851002083
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
024774 Issued in NY
Practice address
156 W 56TH St Ste 1804
New York, NY 10019-3878
Phone
(212) 851-8100
Fax
(212) 537-0102
NPI assigned
Dec 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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 024774 NY Primary

Addresses

Primary practice location

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

Mailing address

1715 Lexington Ave Apt 3
New York, NY 10029-3915
Phone (917) 345-3897

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
I20230104001494 NY Practitioner - Clinical Psychologist 0547630725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinical Psychassociates LLPGroup PAC ID 3072404888, 33 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
024774NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Psychassociates LLP Clinical CurrentSince Dec 12, 2022 Accepting new patients

Locations

18215 Hillside Ave
Jamaica, NY 11432
Phone (718) 262-8651

40 Keogh Ln
New Rochelle, NY 10805
Phone (914) 636-6200

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

27111 76th Ave
North New Hyde Pk, NY 11040
Phone (718) 289-2100

85 Bloomingrove Dr
Troy, NY 12180
Phone (212) 851-8100

Organizations & group practices 1

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": "1670457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1851002083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 LEXINGTON AVE APT 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100293915",
            "telephone_number": "917-345-3897"
        },
        {
            "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": "212-537-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNWELL",
        "first_name": "MELINDA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-08",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.