Individual provider Active NPI

Robert Angelo Pezzote, PHARMD,RPH,NCC,CCMHC

  • Mental Health Counselor
  • New York, NY
National Provider Identifier
1083630867
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
000080 Issued in NY
Practice address
328 W 19TH St
3A
New York, NY 10011-3951
Phone
(917) 673-5003
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 000080 NY Primary
Psychiatric Pharmacist 1835P1300X 049517 NY
Psychiatric Pharmacist 1835P1300X 53470 CA
Psychiatric Pharmacist 1835P1300X PS45136 FL
Marriage & Family Therapist 106H00000X 41291 CA
Psychiatric Pharmacist 1835P1300X 16290 NV
Psychiatric Pharmacist 1835P1300X 20780 NC
Psychiatric Pharmacist 1835P1300X 21831 MA
Psychiatric Pharmacist 1835P1300X PCT0010037 CT
Professional Counselor 101YP2500X LPC118 CA
Mental Health Counselor 101YM0800X MH11320 FL

Addresses

Primary practice location

328 W 19TH St
3A
New York, NY 10011-3951

Mailing address

1602 Alton Rd # 10
Miami Beach, FL 33139-2421
Phone (917) 673-5003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
MH11320FLMDMental Health Counselor
000080NYMDMental Health Counselor
LPC118CAMDProfessional Counselor
41291CAMDMarriage & Family Therapist
53470CAMDGeneral Practice Dentistry
PCT0010037CTMDPsychiatric Pharmacist
PS45136FLMDPsychiatric Pharmacist
21831MAMDPsychiatric Pharmacist
20780NCMDPsychiatric Pharmacist
049517NYMDPsychiatric Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1083630867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 ALTON RD # 10",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331392421",
            "telephone_number": "917-673-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 W 19TH ST",
            "address_2": "3A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100113951",
            "telephone_number": "917-673-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZZOTE",
        "first_name": "ROBERT",
        "middle_name": "ANGELO",
        "name_prefix": "Dr.",
        "credential": "PHARMD,RPH,NCC,CCMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "000080",
            "primary": true
        },
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "NY",
            "license": "049517",
            "primary": false
        },
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "CA",
            "license": "53470",
            "primary": false
        },
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "FL",
            "license": "PS45136",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "41291",
            "primary": false
        },
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "NV",
            "license": "16290",
            "primary": false
        },
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "NC",
            "license": "20780",
            "primary": false
        },
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "MA",
            "license": "21831",
            "primary": false
        },
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "CT",
            "license": "PCT0010037",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "LPC118",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11320",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.