Kristen M Roman, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

021711 Issued in NY

Practice address

113 University Place
Floor 11, Office F
New York, NY 10003

Phone

(646) 760-2778

NPI assigned

May 19, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 4, 2022 through Feb 4, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Kristen Roman Psychology

  • Clinical Psychologist
  • New York, NY
  • NPI 1114783636
  NPD Authorized official
• CBT/DBT Associates

  • Cognitive & Behavioral Psychologist
  • New York, NY
  • NPI 1861883175
  NPD (past)

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

{
    "created_epoch": "1495152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1891222931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 UNIVERSITY PLACE",
            "address_2": "FLOOR 11, OFFICE F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "646-760-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 UNIVERSITY PLACE",
            "address_2": "FLOOR 11, OFFICE F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "646-760-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "KRISTEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-19",
        "last_updated": "2022-05-25",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gladys Roman I
• Janell Roman
• Jose Antonio Roman, CASAC-T
• Jose Roberto Roman, MD
• Kevin C Roman
• Leah Roman
• Madelyn Rose Roman
• Mark Roman, MSW
• Mary J Roman, MD
• Nicole Amanda Roman, MSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.