Individual provider Active NPI

Michelle Hausman, PSY.D.

  • Clinical Psychologist
  • Melville, NY
National Provider Identifier
1891720686
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
015864-1 Issued in NY
Practice address
535 Broadhollow Rd
Suite a-10
Melville, NY 11747-3713
Phone
(631) 249-0011
Fax
(631) 249-1793
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 015864-1 NY Primary

Addresses

Primary practice location

535 Broadhollow Rd
Suite a-10
Melville, NY 11747-3713

Mailing address

535 Broadhollow Rd
Suite a-10
Melville, NY 11747-3713
Phone (631) 249-0011

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
I20040802000166 NY Practitioner - Clinical Psychologist 1658342068 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015864-1NYMDClinical Psychologist
015864NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Healthcare Services PLLC CurrentSince Dec 11, 2013 Accepting new patients
Hospitalist Healthcare Services PLLC Clinical CurrentSince Dec 11, 2013 Accepting new patients
Hospitalist Healthcare Services PLLC Current Accepting new patients
Hospitalist Healthcare Services PLLC Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

420 E 76th St
New York, NY 10021
Phone (212) 434-5300

3 Barker Ave
Fl 4
White Plains, NY 10601
Phone (914) 949-7900

14310 20th Ave
Whitestone, NY 11357
Phone (718) 961-1212

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206662400000",
    "number": "1891720686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 BROADHOLLOW RD",
            "address_2": "SUITE A-10",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117473713",
            "telephone_number": "631-249-0011",
            "fax_number": "631-249-1793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 BROADHOLLOW RD",
            "address_2": "SUITE A-10",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117473713",
            "telephone_number": "631-249-0011",
            "fax_number": "631-249-1793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUSMAN",
        "first_name": "MICHELLE",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "015864-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

Verify at the official NPI Registry.