Active NPI
Andrew Ray Rosendahl, M.D., PH.D.
- Psychiatry Physician
- New York, NY
National Provider Identifier
1932369899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 254452
- Practice address
- 124 W 79TH St
Suite 1E
New York, NY 10024-6470 - Phone
- (646) 820-7792
- Fax
- (855) 532-6102
- NPI assigned
- Jun 13, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 254452 | NY | Primary |
Addresses
Primary practice location
124 W 79TH St
Suite 1E
New York, NY 10024-6470
Mailing address
124 W 79TH St
Suite 1E
New York, NY 10024-6470
Phone (646) 820-7792
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2021 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 254452 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342310400000",
"number": "1932369899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 W 79TH ST",
"address_2": "SUITE 1E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100246470",
"telephone_number": "646-820-7792",
"fax_number": "855-532-6102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 W 79TH ST",
"address_2": "SUITE 1E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100246470",
"telephone_number": "646-820-7792",
"fax_number": "855-532-6102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENDAHL",
"first_name": "ANDREW",
"middle_name": "RAY",
"name_prefix": "Dr.",
"credential": "M.D., PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-13",
"last_updated": "2012-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "254452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.