Active NPI
Richard Victor Primo, PH.D.
- Clinical Psychologist
- Lewiston, NY
National Provider Identifier
1093813958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5110-01
- Practice address
- 120 N 7TH St
Lewiston, NY 14092-1306 - Phone
- (716) 754-4866
- NPI assigned
- Sep 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 5110-01 | NY | Primary |
Addresses
Primary practice location
120 N 7TH St
Lewiston, NY 14092-1306
Mailing address
PO Box 712
Lewiston, NY 14092-0712
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00633418 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5110-01 | NY | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of New York Comptrollers Office | Past | Accepting new patients |
Organizations & group practices 1
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.
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- Staten Island, NY
- NPI 1750469912
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788652800000",
"number": "1093813958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 712",
"city": "LEWISTON",
"state": "NY",
"postal_code": "140920712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 N 7TH ST",
"city": "LEWISTON",
"state": "NY",
"postal_code": "140921306",
"telephone_number": "716-754-4866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIMO",
"first_name": "RICHARD",
"middle_name": "VICTOR",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2026-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "5110-01",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00633418",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lewiston, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.