Individual provider Active NPI

Paul G Schulze, PSYD

  • Clinical Psychologist
  • Queensbury, NY
National Provider Identifier
1952493538
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0105112 Issued in NY
Practice address
123 Dixon Rd
Queensbury, NY 12804-2133
Phone
(518) 798-2088
Fax
(518) 792-8632
NPI assigned
Sep 29, 2006
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
Clinical Psychologist 103TC0700X 0105112 NY Primary

Addresses

Primary practice location

123 Dixon Rd
Queensbury, NY 12804-2133

Mailing address

123 Dixon Rd
Queensbury, NY 12804-2133
Phone (518) 798-2088

Other identifiers 1

IdentifierTypeStateIssuer
01675901MedicaidNY

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
I20100420000382 NY Practitioner - Clinical Psychologist 2264569441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

123 Dixon Rd
Queensbury, NY 12804-2133
Phone (518) 798-2088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0105112NYMDClinical Psychologist
010511NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Adirondack Cross Roads Psychology PLLC Clinical CurrentSince Jan 1, 1999 Accepting new patients

Locations

123 Dixon Rd
Queensbury, NY 12804
Phone (518) 792-8500

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952493538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 DIXON RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128042133",
            "telephone_number": "518-798-2088",
            "fax_number": "518-792-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 DIXON RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128042133",
            "telephone_number": "518-798-2088",
            "fax_number": "518-792-8632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULZE",
        "first_name": "PAUL",
        "middle_name": "G",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "0105112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01675901",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Queensbury, NY

Sources for this page

Verify at the official NPI Registry.