Individual provider Active NPI

Afton N. Kapuscinski, PH.D.

  • Psychologist
  • Syracuse, NY
National Provider Identifier
1912327495
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
68 020537 Issued in NY
Practice address
765 Irving Ave RM 314
Syracuse, NY 13210-1625
Phone
(315) 443-3595
NPI assigned
Apr 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 68 020537 NY Primary

Addresses

Primary practice location

765 Irving Ave RM 314
Syracuse, NY 13210-1625

Mailing address

765 Irving Ave RM 314
Syracuse, NY 13244-2340
Phone (315) 443-3595

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
I20210505000959 NY Practitioner - Clinical Psychologist 8628487501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychiatry Faculty Practice, IncGroup PAC ID 9234458530, 90 clinicians

Practice addresses (Care Compare)

719 Harrison St
Syracuse, NY 13210-2695
Phone (315) 464-3265

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68 020537NYMDPsychologist
020537NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatry Faculty Practice, Inc. CurrentSince Mar 24, 2021 Accepting new patients
Syracuse University Psychologist Past Accepting new patients

Locations

713 Harrison St
Bldg 3
Syracuse, NY 13210
Phone (315) 464-3265

719 Harrison St
Syracuse, NY 13210
Phone (315) 464-3265

Organizations & group practices 2

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": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1912327495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 IRVING AVE RM 314",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132442340",
            "telephone_number": "315-443-3595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 IRVING AVE RM 314",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101625",
            "telephone_number": "315-443-3595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPUSCINSKI",
        "first_name": "AFTON",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "68 020537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.