Individual provider Active NPI

Jane W. Bloomgarden, PHD

  • Clinical Psychologist
  • Scarsdale, NY
National Provider Identifier
1861153629
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
NYS006556-1 Issued in NY
Practice address
68 Brookby Rd
Scarsdale, NY 10583-4543
Phone
(914) 393-7029
NPI assigned
Jan 4, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 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 NYS006556-1 NY Primary

Addresses

Primary practice location

68 Brookby Rd
Scarsdale, NY 10583-4543

Mailing address

68 Brookby Rd
Scarsdale, NY 10583-4543
Phone (914) 393-7029

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
NYS006556-1NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1861153629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 BROOKBY RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105834543",
            "telephone_number": "914-393-7029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 BROOKBY RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105834543",
            "telephone_number": "914-393-7029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOMGARDEN",
        "first_name": "JANE",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "NYS006556-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarsdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.