Individual provider Active NPI

Nicholas Sitro, PSY.D.

  • Clinical Psychologist
  • Norwich, CT
National Provider Identifier
1083490304
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4617 Issued in CT
Practice address
150 Otrobando Ave
Norwich, CT 06360-2116
Phone
(860) 889-7274
Fax
(860) 889-2131
NPI assigned
Sep 1, 2023
Last updated
Sep 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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 4617 CT Primary

Addresses

Primary practice location

150 Otrobando Ave
Norwich, CT 06360-2116

Mailing address

150 Otrobando Ave
Norwich, CT 06360-2116
Phone (860) 889-7274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20230920001956 CT Practitioner - Clinical Psychologist 6002260312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Connecticut Neuropsychological Associates LLCGroup PAC ID 9638494446, 13 clinicians

Practice addresses (Care Compare)

150 Otrobando Ave
Norwich, CT 06360-2116
Phone (860) 889-7274

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4617CTMDClinical Psychologist
004617CTMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Neuropsychological Associates, LLC Clinical CurrentSince Sep 1, 2023 Accepting new patients
Eastern Connecticut Rehabili PastSince Sep 1, 2023 Accepting new patients

Locations

150 Otrobando Ave
Norwich, CT 06360
Phone (860) 889-1948

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1693526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1083490304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 OTROBANDO AVE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602116",
            "telephone_number": "860-889-7274",
            "fax_number": "860-889-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 OTROBANDO AVE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602116",
            "telephone_number": "860-889-7274",
            "fax_number": "860-889-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SITRO",
        "first_name": "NICHOLAS",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-01",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "4617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.