Individual provider Active NPI

Kristine M Augustyniak, PHD

  • Psychologist
  • Lewiston, NY
National Provider Identifier
1861650566
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0136822 Issued in NY
Practice address
765 Cayuga St
Suite 1
Lewiston, NY 14092
Phone
(716) 327-1094
Fax
(716) 405-7717
NPI assigned
May 29, 2008
Last updated
Apr 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 0136822 NY Primary
Clinical Psychologist 103TC0700X 013682 NY

Addresses

Primary practice location

765 Cayuga St
Suite 1
Lewiston, NY 14092

Mailing address

765 Cayuga St
Suite 1
Lewiston, NY 14092
Phone (716) 327-1094

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
I20080626000272 NY Practitioner - Clinical Psychologist 2567534175 Practice locations: Lewiston, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

765 Cayuga St
Apt 1
Lewiston, NY 14092-1726
Phone (716) 327-1094

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0136822NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1861650566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 CAYUGA ST",
            "address_2": "SUITE 1",
            "city": "LEWISTON",
            "state": "NY",
            "postal_code": "14092",
            "telephone_number": "716-327-1094",
            "fax_number": "716-405-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 CAYUGA ST",
            "address_2": "SUITE 1",
            "city": "LEWISTON",
            "state": "NY",
            "postal_code": "14092",
            "telephone_number": "716-327-1094",
            "fax_number": "716-405-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUGUSTYNIAK",
        "first_name": "KRISTINE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-29",
        "last_updated": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "0136822",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "013682",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, NY

Sources for this page

Verify at the official NPI Registry.