J. RYAN FULLER PH.D.
NPI 1871712653
Psychologist in New York, NY

Active since April 24, 2007Opted out of Medicare · through Oct 1, 2027
909 THIRD AVE., SUITE 505 NEW YORK BEHAVIORAL HEALTH,, NEW YORK, NY 10022(646) 495-3078 Get Directions Write a Review

NPPES record last updated: August 20, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About J. Ryan Fuller Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

J. RYAN FULLER PH.D. (NPI 1871712653) is an individual psychologist in New York, New York, licensed in New York (017108) and active in the NPI registry since April 2007. He has opted out of Medicare through October 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1871712653
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameJ. RYAN FULLERCredential: PH.D.
Location Address909 THIRD AVE., SUITE 505 NEW YORK BEHAVIORAL HEALTH,New York, NY 10022
Mailing Address909 3rd Ave, Suite 505New York, NY 10022-4731 · (646) 495-3078
Sole ProprietorYes
Enumeration DateApril 24, 2007
Last NPPES UpdateAugust 20, 2009
NPI 1871712653 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in NY · 017108
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
909 THIRD AVE., New York, NY 10022

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

J. Ryan Fuller Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2017 through October 1, 2027.

Opt-Out Effective DateOctober 1, 2017
Opt-Out In Effect ThroughOctober 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is J. Ryan Fuller's NPI number?

The NPI number for J. Ryan Fuller is 1871712653. It was assigned to this individual provider in the NPPES registry on April 24, 2007.

Where is J. Ryan Fuller located?

J. Ryan Fuller practices at 909 Third Ave. Suite 505 New York Behavioral Health,, New York, NY 10022. The listed phone number is (646) 495-3078.

What is J. Ryan Fuller's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is J. Ryan Fuller enrolled in Medicare?

No. J. Ryan Fuller has opted out of Medicare through October 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for J. Ryan Fuller was last updated on August 20, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.