Individual provider Active NPI

Ruth Mutzner, PHD

  • Psychologist
  • Hartsdale, NY
National Provider Identifier
1982640835
Registry record updated Aug 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
012405 Issued in NY
Practice address
35 E Hartsdale Ave
Hartsdale, NY 10530-2742
Phone
(914) 552-2477
Fax
(914) 831-0637
NPI assigned
Jun 21, 2006
Last updated
Aug 14, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 012405 NY Primary

Addresses

Primary practice location

35 E Hartsdale Ave
Hartsdale, NY 10530-2742

Mailing address

35 E Hartsdale Ave
Hartsdale, NY 10530-2742
Phone (914) 552-2477

Other identifiers 2

IdentifierTypeStateIssuer
01763368MedicaidNY
03497OtherNYGHI PSYCHOLOGIST

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
I20090220000467 NY Practitioner - Clinical Psychologist 3476618786 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY; Far Rockaway, NY; Hartsdale, NY; Kingston, NY; Queens, NY; Tarrytown, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

35 E Hartsdale Ave
Apt 1D
Hartsdale, NY 10530-2745
Phone (914) 552-2477

9028 Van Wyck Expressway
Queens, NY 11418-2898
Phone (914) 552-2477

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Benzaquen Psychological Services, PLLC CurrentSince Dec 7, 2011 Accepting new patients
Hudson Valley Senior Residence Past Accepting new patients
DRS. Engel and Lindgren Family Medicine, P.C. Past Accepting new patients

Locations

143 Maple Ave
Cedarhurst, NY 11516
Phone (516) 295-4104

1441 Gateway Blvd
Far Rockaway, NY 11691
Phone (718) 471-1500

645 W Broadway
Long Beach, NY 11561
Phone (516) 431-4400

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218672000000",
    "number": "1982640835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 E HARTSDALE AVE",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105302742",
            "telephone_number": "914-552-2477",
            "fax_number": "914-831-0637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 E HARTSDALE AVE",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105302742",
            "telephone_number": "914-552-2477",
            "fax_number": "914-831-0637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTZNER",
        "first_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2008-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "012405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01763368",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PSYCHOLOGIST",
            "identifier": "03497",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsdale, NY

Sources for this page

Verify at the official NPI Registry.