Active NPI
Richard Scallon, PH.D.
- Clinical Psychologist
- Queens Village, NY
National Provider Identifier
1952323164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 003586-1
- Practice address
- 11030 221St St
Queens Village, NY 11429-2531 - Phone
- (718) 464-1800
- NPI assigned
- Jul 24, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 003586-1 | NY | Primary |
Addresses
Primary practice location
11030 221St St
Queens Village, NY 11429-2531
Mailing address
1 Old Country Rd
Suite 271
Carle Place, NY 11514-1801
Phone (800) 725-6280
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01655229 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003586-1 | NY | MD | Clinical Psychologist |
| 003586 | NY | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospitalist Healthcare Services PLLC | Past | 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 and National Provider Directory roles.
-
- Internal Medicine Physician
- White Plains, NY
- NPI 1275962011
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952323164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 OLD COUNTRY RD",
"address_2": "SUITE 271",
"city": "CARLE PLACE",
"state": "NY",
"postal_code": "115141801",
"telephone_number": "800-725-6280",
"fax_number": "800-725-6380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11030 221ST ST",
"city": "QUEENS VILLAGE",
"state": "NY",
"postal_code": "114292531",
"telephone_number": "718-464-1800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCALLON",
"first_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "003586-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01655229",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Queens Village, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.