Individual provider Active NPI

Elisa M Vega, PSYD

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1093024408
Registry record updated Apr 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
022592 Issued in NY
Practice address
3512 Quentin Rd
Brooklyn, NY 11234-4244
Phone
(800) 275-3243
NPI assigned
Oct 3, 2010
Last updated
Apr 6, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2018

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 022592 NY Primary

Addresses

Primary practice location

3512 Quentin Rd
Brooklyn, NY 11234-4244

Mailing address

9801 67TH Ave Apt 1K
Rego Park, NY 11374-4901

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
I20180522000997 NY Practitioner - Clinical Psychologist 4981969979 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Care Therapy Psychology of New York PLLCGroup PAC ID 2264774793, 10 clinicians

Practice addresses (Care Compare)

14415 68TH Rd
Flushing, NY 11367-1330
Phone (973) 264-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
022592NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC Clinical CurrentSince Apr 9, 2018 Accepting new patients
Knapp Street Psychiatry, PC Clinical CurrentSince Apr 9, 2018 Accepting new patients
Senior Care Therapy Psychology of New York PLLC Clinical CurrentSince Jun 1, 2025 Accepting new patients

Locations

2719 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 354-2555

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

3512 Quentin Rd
Ste 110
Brooklyn, NY 11234
Phone (718) 854-8370

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) 420-1934

Organizations & group practices 3

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": "1286064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522972800000",
    "number": "1093024408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9801 67TH AVE APT 1K",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 QUENTIN RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112344244",
            "telephone_number": "800-275-3243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA",
        "first_name": "ELISA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-03",
        "last_updated": "2018-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "022592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.