Susan Elisabeth Palmgren, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

017203-1 Issued in NY

Practice address

1090 Amsterdam Ave
New York, NY 10025-1737

Phone

(212) 523-5134

Fax

(212) 523-4069

NPI assigned

Dec 28, 2006

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

Other names 1

• Mrs. Susan Elisabeth Packard Former name

Medicare fee-for-service enrollment

Enrolled in NY, ME2 enrollments

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 2

Specialty

Clinical Psychologist

Education

Other, 2006

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Bayside Psychology and Consulting LLCGroup PAC ID 1850728858, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Bayside Psychology and Consulting, LLC

  • Psychologist
  • Portland, ME
  • NPI 1639637432
  Medicare reassignment Care Compare group NPD
• Harlem Medical Associates PC

  • General Practice Physician
  • New York, NY
  • NPI 1487957692
  Medicare reassignment NPD

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398038400000",
    "number": "1912063785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251737",
            "telephone_number": "212-523-5134",
            "fax_number": "212-523-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251737",
            "telephone_number": "212-523-5134",
            "fax_number": "212-523-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMGREN",
        "first_name": "SUSAN",
        "middle_name": "ELISABETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2014-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "017203-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "PACKARD",
            "middle_name": "ELISABETH",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Victoria Palmeri, CF
• Yovani Palmeri, PA
• Tullio Palmerini, MD
• Katherine Ludlow Palmerola, MD
• Christina Ann Palmese, PHD
• Mila Kirstie Clarin Palmieri, PH.D.
• Vincent Paul Palmieri, FNP
• Erica Palmiero, PMHNP
• Kristin Marie Palmiero, RPA-C
• Carrie Elizabeth Palmisano, PA-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; 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.