NPIMap

Organization Active NPI

Adjuvant Behavioral Health Inc

  • Multi-Specialty Clinic/Center
  • New York, NY
National Provider Identifier
1861203911
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ADJUVANT BEHAVIORAL HEALTH INC
Practice address
136 Madison Ave
New York, NY 10016-6711
Phone
(866) 912-2746
Fax
(800) 420-2305
NPI assigned
Jan 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Authorized official

Name
Elizabeth Myers
Title
Contract Credentialing Specialist
Phone
(866) 912-2746

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

136 Madison Ave
New York, NY 10016-6711

Mailing address

11754 Jollyville Rd Ste 110
Austin, TX 78759-3948
Phone (866) 912-2746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250514000324 NY Part B Supplier - Clinic/Group Practice 2860865557 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Adjuvant Behavioral Parkway11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11754 Jollyville Rd
Ste 110
Austin, TX 78759
Phone (512) 331-2700

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1737072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737072000000",
    "number": "1861203911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11754 JOLLYVILLE RD STE 110",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787593948",
            "telephone_number": "866-912-2746",
            "fax_number": "800-420-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166711",
            "telephone_number": "866-912-2746",
            "fax_number": "800-420-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADJUVANT BEHAVIORAL HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-17",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "CONTRACT CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "866-912-2746"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "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 Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.