Individual provider Active NPI

Vincent Mario Pignatiello II, PSYD

  • Clinical Psychologist
  • Keene, NH
National Provider Identifier
1043695307
Registry record updated Dec 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1341 Issued in NH
Practice address
191 Washington St
Keene, NH 03431-3154
Phone
(802) 266-0603
Fax
(833) 262-3712
NPI assigned
Jul 28, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2024

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 1341 NH Primary

Addresses

Primary practice location

191 Washington St
Keene, NH 03431-3154

Mailing address

191 Washington St
Keene, NH 03431-3154
Phone (802) 266-0603

Other practice location 1

40 Avon St
Keene, NH 03431-3516
Phone (802) 266-0603

Other identifiers 1

IdentifierTypeStateIssuer
3101924MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20151110000028 NH Practitioner - Clinical Psychologist 9830409531 Practice locations: Keene, NH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

191 Washington St
Keene, NH 03431-3154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1341NHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Monadnock Family Services PastSince Apr 9, 2024 Accepting new patients

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": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733616000000",
    "number": "1043695307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 WASHINGTON ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034313154",
            "telephone_number": "802-266-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 WASHINGTON ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034313154",
            "telephone_number": "802-266-0603",
            "fax_number": "833-262-3712"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Avon St",
            "address_purpose": "LOCATION",
            "city": "Keene",
            "state": "NH",
            "postal_code": "034313516",
            "country_code": "US",
            "telephone_number": "802-266-0603",
            "fax_number": "833-262-3712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIGNATIELLO",
        "first_name": "VINCENT",
        "middle_name": "MARIO",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-28",
        "last_updated": "2024-12-08",
        "certification_date": "2024-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NH",
            "license": "1341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3101924",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

Verify at the official NPI Registry.