NPIMap

Individual provider Active NPI

Carly Schuller

  • Student in an Organized Health Care Education/Training Program
  • Hartsdale, NY
National Provider Identifier
1871106856
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
141 N Central Ave
Hartsdale, NY 10530-1912
Phone
(914) 949-7699
Fax
(914) 949-3224
NPI assigned
Aug 28, 2020
Last updated
Dec 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

141 N Central Ave
Hartsdale, NY 10530-1912

Mailing address

845 N Broadway
White Plains, NY 10603-2427
Phone (914) 761-0600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cschuller653984@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240501003610 UT Practitioner - Clinical Psychologist 6901246347 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Pediatric Behavioral Health Services CurrentSince Apr 1, 2024 Accepting new patients
University of Utah Pediatric Behavioral Health Services CurrentSince Apr 1, 2024 Accepting new patients
University of Utah Pediatric Behavioral Health Services Current Accepting new patients
University of Utah Behavioral Health Services CurrentSince Apr 1, 2024 Accepting new patients
University of Utah Behavioral Health Services CurrentSince Apr 1, 2024 Accepting new patients
University of Utah Behavioral Health Services Current Accepting new patients

Locations

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

501 S Chipeta Way
Slc, UT 84108
Phone (801) 581-7951

Interoperability endpoints

  • Direct secure messaging: cschuller653984@direct.med.utah.edu

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1871106856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 N BROADWAY",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106032427",
            "telephone_number": "914-761-0600",
            "fax_number": "914-761-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 N CENTRAL AVE",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301912",
            "telephone_number": "914-949-7699",
            "fax_number": "914-949-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULLER",
        "first_name": "CARLY",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cschuller653984@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hartsdale, NY

Sources for this page

Verify at the official NPI Registry.