Individual provider Active NPI

Amanda L Sweet, PSY.D.

  • Psychologist
  • Watertown, NY
National Provider Identifier
1992120430
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
021062 Issued in NY
Practice address
22670 Summit Dr Ste B
Watertown, NY 13601-7209
Phone
(315) 788-3332
NPI assigned
Feb 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY10061 FL
Psychologist 103T00000X 021062 NY Primary

Addresses

Primary practice location

22670 Summit Dr Ste B
Watertown, NY 13601-7209

Mailing address

22670 Summit Dr Ste 2
Watertown, NY 13601-7208
Phone (315) 775-3790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150915001358 NY Practitioner - Clinical Psychologist 3274840889 Reassigns benefits to 1 organization
I20201211000404 FL Practitioner - Clinical Psychologist 3274840889 Practice locations: Port Charlotte, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nysarc Inc. Onondaga County ChapterGroup PAC ID 9537252184, 19 clinicians

Practice addresses (Care Compare)

600 S Wilbur Ave
Syracuse, NY 13204-2730
Phone (315) 476-7441

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY10061FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nysarc Inc. Onondaga County Chapter CurrentSince Feb 16, 2024 Accepting new patients

Locations

600 S Wilbur Ave
Syracuse, NY 13204
Phone (315) 476-7441

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": "1392854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1992120430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22670 SUMMIT DR STE 2",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136017208",
            "telephone_number": "315-775-3790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22670 SUMMIT DR STE B",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136017209",
            "telephone_number": "315-788-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEET",
        "first_name": "AMANDA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-20",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY10061",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "021062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.