Active NPI
Katherine Marie Muir, PH.D
- Clinical Psychologist
- Patchogue, NY
National Provider Identifier
1982802708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 008630-1
- Practice address
- 450 Waverly Ave Ste 11
Patchogue, NY 11772-1555 - Phone
- (631) 338-0671
- NPI assigned
- Jul 3, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 008630-1 | NY | Primary |
Addresses
Primary practice location
450 Waverly Ave Ste 11
Patchogue, NY 11772-1555
Mailing address
4 Oakhurst Rd
Hampton Bays, NY 11946-1555
Phone (631) 338-0671
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120223000054 | NY | Practitioner - Clinical Psychologist | 0648438507 | Practice locations: Patchogue, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
43 Astor Ave
Brookhaven, NY 11719-9749
450 Waverly Ave
Suite 11
Patchogue, NY 11772-1555
Phone (631) 338-0671
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008630-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1982802708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 OAKHURST RD",
"city": "HAMPTON BAYS",
"state": "NY",
"postal_code": "119461555",
"telephone_number": "631-338-0671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 WAVERLY AVE STE 11",
"city": "PATCHOGUE",
"state": "NY",
"postal_code": "117721555",
"telephone_number": "631-338-0671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUIR",
"first_name": "KATHERINE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-03",
"last_updated": "2020-11-17",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "008630-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Patchogue, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.