Mayimuna Y Pettiford, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

019680 Issued in NY

Practice address

214 W Houston St
New York, NY 10014-4846

Phone

(212) 337-9400

NPI assigned

Oct 5, 2012

Last updated

Oct 5, 2012By the provider in NPPES

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

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

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinical Psychassociates LLPGroup PAC ID 3072404888, 33 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jamaica Hospital Medical Center Hospital, Jamaica, NY, CCN 330014

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Clinical Psychassociates LLP

  • Clinical Psychologist
  • New York, NY
  • NPI 1124051925
  Medicare reassignment Care Compare group NPD
• Flushing Hospital & Medical Center

  • General Acute Care Hospital
  • Flushing, NY
  • NPI 1548217763
  Medicare reassignment NPD
• Jamaica Hospital

  dba Jamaica Hospital Emergency Department - Radiology

  • Emergency Medical Services (Emergency Medicine) Physician
  • Jamaica, NY
  • NPI 1477505220
  Medicare reassignment NPD
• Senior Care Therapy LCSW of New York PLLC

  • Clinical Social Worker
  • Flushing, NY
  • NPI 1932677168
  Medicare reassignment NPD
• Senior Care Therapy Psychology of New York PLLC

  • Clinical Psychologist
  • Flushing, NY
  • NPI 1437628203
  Medicare reassignment NPD
• Flushing Hospital Medical Center

  • Skilled Nursing Facility
  • Flushing, NY
  • NPI 1568693174
  NPD
• Jamaica Hospital

  • Skilled Nursing Facility
  • Jamaica, NY
  • NPI 1750516795
  NPD
• Che Senior Psychological Services, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1023078219
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jamaica Hospital

  • General Acute Care Hospital
  • Richmond Hill, NY
  • NPI 1245370717
  Care Compare affiliation

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1902158538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 MERRICK RD",
            "address_2": "SUITE 204",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115632501",
            "telephone_number": "800-725-6280",
            "fax_number": "800-725-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 W HOUSTON ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100144846",
            "telephone_number": "212-337-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIFORD",
        "first_name": "MAYIMUNA",
        "middle_name": "Y",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-05",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claire Pettengill, RN
• Stephanie Petterson Pogemiller, PT
• Anthony Petti, AU.D.
• Derek Petti
• Darious Everett Pettiford
• Xylina Pettiford
• Kara Pettigen, RN
• Althea Pettigrew
• Christopher John Pettit
• Emma Pettit

• 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 Oct 5, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.