Individual provider Active NPI

Susan G Pomerantz, PH.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1902289531
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
021155 Issued in NY
Practice address
240 West End Avenue
Suite 1B
New York, NY 10023
Phone
(201) 822-1442
NPI assigned
Jul 1, 2015
Last updated
Jul 1, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 021155 NY Primary

Addresses

Primary practice location

240 West End Avenue
Suite 1B
New York, NY 10023

Mailing address

16 S Mountain Rd
Millburn, NJ 07041-1506
Phone (973) 699-8455

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
I20151005000635 NY Practitioner - Clinical Psychologist 2769790112 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

240 W End Ave
1B
New York, NY 10023-0137
Phone (201) 822-1442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Robert Riordan-Clinical Psychologist PLLC PastSince Oct 1, 2012 Accepting new patients

Organizations & group practices 1

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": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1902289531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 S MOUNTAIN RD",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411506",
            "telephone_number": "973-699-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 WEST END AVENUE",
            "address_2": "SUITE 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10023",
            "telephone_number": "201-822-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMERANTZ",
        "first_name": "SUSAN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "021155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.