Individual provider Active NPI

Michael Anthony O'Loughlin, PH.D.

  • Clinical Psychologist
  • New Hyde Park, NY
National Provider Identifier
1982822003
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
014848 Issued in NY
Practice address
15 Laurel Dr
New Hyde Park, NY 11040-2148
Phone
(516) 414-4438
Fax
(516) 775-6131
NPI assigned
Apr 23, 2007
Sex
Male
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
Clinical Psychologist 103TC0700X 014848 NY Primary

Addresses

Primary practice location

15 Laurel Dr
New Hyde Park, NY 11040-2148

Mailing address

15 Laurel Dr
New Hyde Park, NY 11040-2148
Phone (516) 414-4438

Other identifiers 1

IdentifierTypeStateIssuer
02228962MedicaidNY

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
I20250108003354 NY Practitioner - Clinical Psychologist 2769910454 Practice locations: New Hyde Park, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

15 Laurel Dr
New Hyde Park, NY 11040-2148
Phone (516) 414-4438

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982822003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LAUREL DR",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402148",
            "telephone_number": "516-414-4438",
            "fax_number": "516-775-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 LAUREL DR",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110402148",
            "telephone_number": "516-414-4438",
            "fax_number": "516-775-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'LOUGHLIN",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "014848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02228962",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.