Jacqueline Sue Degroat, M.S.ED., PSY.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

018431-1 Issued in NY

Practice address

816 Ditmas Ave
Brooklyn, NY 11218-5204

Phone

(718) 531-1800

Fax

(718) 859-5909

NPI assigned

Jan 6, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

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.

• Community Assistance Resources & Extended Services Inc

  • Case Management Agency
  • New York, NY
  • NPI 1396049987
  Medicare reassignment NPD

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

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1073843462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 DITMAS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112185204",
            "telephone_number": "718-531-1800",
            "fax_number": "718-859-5909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 DITMAS AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112185204",
            "telephone_number": "718-531-1800",
            "fax_number": "718-859-5909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "465 Grand St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100027477",
            "country_code": "US",
            "telephone_number": "212-429-1970",
            "fax_number": "212-420-1906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEGROAT",
        "first_name": "JACQUELINE",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "M.S.ED., PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-06",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "018431-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roberta Degnore
• Ana Cecilia Degoy-Shahin, MD
• Joan Degregorio, LCSW, ACSW
• Danielad Degrezia, PHARMD
• Rosanna Degrezia, OTR/L
• Daria Degtyareva
• Ella Degtyareva, M.D.
• Margarita Degtyareva, DDS
• Olga Degtyareva, DDS
• Christopher Deguzman, OTR

• Clinical Child & Adolescent Psychologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Child & Adolescent Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.