Individual provider Active NPI

Josephine Loiacono-Donovan, PSYD

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1083770929
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
013537 Issued in NY
Practice address
1329-49TH Street
Brooklyn, NY 11219
Phone
(917) 975-9186
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 013537 NY Primary

Addresses

Primary practice location

1329-49TH Street
Brooklyn, NY 11219

Mailing address

2228-63Rd St.
Brooklyn, NY 11204
Phone (917) 975-9186

Other identifiers 1

IdentifierTypeStateIssuer
013537OtherNYLICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100914000449 NY Practitioner - Clinical Psychologist 1658496708 Reassigns benefits to 4 organizations
Practice locations: Staten Island, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013537NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Adult Care Psychology Services, PLLC Clinical CurrentSince Nov 1, 2016 Accepting new patients
Coney Island Medical Practice Plan, P.C. CurrentSince May 2, 2012 Accepting new patients
Che Senior Psychological Services, PC Clinical CurrentSince Jul 10, 2010 Accepting new patients
Knapp Street Psychiatry, PC Clinical CurrentSince Jul 11, 2010 Accepting new patients

Locations

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101

797 Brighton Ave
Staten Island, NY 10301
Phone (718) 477-6900

Organizations & group practices 4

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": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083770929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2228-63RD ST.",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11204",
            "telephone_number": "917-975-9186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329-49TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11219",
            "telephone_number": "917-975-9186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOIACONO-DONOVAN",
        "first_name": "JOSEPHINE",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "013537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "013537",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.