Richard Michael Damato, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP019321 Issued in PA

Practice address

1528 Walnut St Ste 1414
Philadelphia, PA 19102-3610

Phone

(267) 331-4002

Fax

(267) 331-4002

NPI assigned

Sep 25, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 6, 2019 through Nov 6, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Risenow Autism Innovations LLC

  • Developmental Disabilities Clinic/Center
  • Paoli, PA
  • NPI 1124912746

  Psychiatric/Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1023593191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 WALNUT ST STE 1414",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191023610",
            "telephone_number": "267-331-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 WALNUT ST STE 1414",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191023610",
            "telephone_number": "267-331-4002",
            "fax_number": "267-331-4002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 S Valley Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Paoli",
            "state": "PA",
            "postal_code": "193011450",
            "country_code": "US",
            "telephone_number": "267-331-4002",
            "fax_number": "267-331-4002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1615 S Congress Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "Delray Beach",
            "state": "FL",
            "postal_code": "334456326",
            "country_code": "US",
            "telephone_number": "267-331-4002",
            "fax_number": "267-331-4002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 N West St Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198011058",
            "country_code": "US",
            "telephone_number": "267-331-4002",
            "fax_number": "267-331-4002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Grant St Ste 270",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152191408",
            "country_code": "US",
            "telephone_number": "267-331-4002",
            "fax_number": "267-331-4002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3477 Corporate Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Center Valley",
            "state": "PA",
            "postal_code": "180348237",
            "country_code": "US",
            "telephone_number": "484-763-4025",
            "fax_number": "267-331-4002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5 Penn Plz Fl 23",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100011810",
            "country_code": "US",
            "telephone_number": "332-219-7898",
            "fax_number": "267-331-4002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAMATO",
        "first_name": "RICHARD",
        "middle_name": "MICHAEL",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-25",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01163300",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DE",
            "license": "L8-0010596",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11033113",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP019321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Daly, LPC, CAADC
• Thomas Gordon Daly, PT, DPT
• Catherine Lauren Dalyai, CRNP
• Kristin Marie Dalzell, MA
• Mausam Rajesh Damani, M.D.
• Catherine Dambach, LSW
• Megan Ann Dambrosio
• Kevin Martin Dames
• Julie Lee Dameus
• Ashley Brynn Damian, CRNP

• Psychiatric/Mental Health Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.