Individual provider Active NPI

Joel Howard Kuppersmith, PH.D.

  • Psychologist
  • Huntington, NY
National Provider Identifier
1912076977
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6015 Issued in NY
Practice address
177 Main St
Huntington, NY 11743-6917
Phone
(631) 271-3870
Fax
(631) 271-3870
NPI assigned
Nov 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6015 NY Primary

Addresses

Primary practice location

177 Main St
Huntington, NY 11743-6917

Mailing address

177 Main St
Huntington, NY 11743-6917
Phone (631) 271-3870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 20, 2023 through Jun 20, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6015NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912076977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 MAIN ST",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117436917",
            "telephone_number": "631-271-3870",
            "fax_number": "631-271-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 MAIN ST",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117436917",
            "telephone_number": "631-271-3870",
            "fax_number": "631-271-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPPERSMITH",
        "first_name": "JOEL",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "6015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.