Individual provider Active NPI

Linda Rachelle Grad, PHD

  • Psychologist
  • New York, NY
National Provider Identifier
1952446353
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
NY8732 Issued in NY
Practice address
135 East 50TH St
Suite 100
New York, NY 10022
Phone
(212) 813-8084
Fax
(212) 717-8150
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

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 NY8732 NY Primary

Addresses

Primary practice location

135 East 50TH St
Suite 100
New York, NY 10022

Mailing address

135 East 50TH St
Suite 100
New York, NY 10022
Phone (212) 813-8084

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
I20050516000151 NY Practitioner - Clinical Psychologist 0840231346 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

177 E 75TH St
Apt 5C
New York, NY 10021-3231
Phone (917) 693-0632

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NY8732NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952446353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 EAST 50TH ST",
            "address_2": "SUITE 100",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10022",
            "telephone_number": "212-813-8084",
            "fax_number": "212-717-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 EAST 50TH ST",
            "address_2": "SUITE 100",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10022",
            "telephone_number": "212-813-8084",
            "fax_number": "212-717-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAD",
        "first_name": "LINDA",
        "middle_name": "RACHELLE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "NY8732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.