Active NPI
Richard Waxman, PH.D.
- Psychologist
- Bronx, NY
National Provider Identifier
1972665164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 007156-1
- Practice address
- 235 E 149TH St
Bronx, NY 10451-5523 - Phone
- (718) 579-5232
- NPI assigned
- Dec 14, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 007156-1 | NY | Primary |
Addresses
Primary practice location
235 E 149TH St
Bronx, NY 10451-5523
Mailing address
168 - 07 71 Avenue
Flushing, NY 11365
Phone (718) 969-7410
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 |
|---|---|---|---|
| 007156-1 | NY | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prime Time Care, Inc. | 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.
-
- Local Education Agency (LEA)
- Flushing, NY
- NPI 1700194461
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972665164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "168 - 07 71 AVENUE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "11365",
"telephone_number": "718-969-7410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 E 149TH ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104515523",
"telephone_number": "718-579-5232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAXMAN",
"first_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "007156-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, 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.