Ryan W Peterson, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

019091-1 Issued in NY

Practice address

115 Liberty St
Bath, NY 14810-1508

Phone

(607) 776-6577

Fax

(607) 664-2161

NPI assigned

Sep 14, 2007

Last updated

Jul 24, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rpeterson@steubencodss.direct.rrhio.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of Steuben

  dba Steuben County Public Health

  • State or Local Public Health Clinic/Center
  • Bath, NY
  • NPI 1053469346
  NPD
• County of Steuben

  • Land Ambulance
  • Bath, NY
  • NPI 1750130043
  NPD
• County of Steuben

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bath, NY
  • NPI 1982709846
  NPD

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1861688608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 LIBERTY ST",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148101508",
            "telephone_number": "607-776-6577",
            "fax_number": "607-664-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 LIBERTY ST",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148101508",
            "telephone_number": "607-776-6577",
            "fax_number": "607-664-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "RYAN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-14",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "019091-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pathways, Inc
• Laura Paul, FNP
• Cassandra Paulchel, M.S, OTR/L
• Lauren Peffer
• Cindy E Perkins
• Rebekah Phelps, MSW
• Cindy L Phifer, CASAC-T
• Carlie Phillips, PSY.D.
• Matthew Pietro, PHARM.D.
• Krystal Potter

• Psychologist in Bath, NY
• Providers in Bath, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.