Patrick G. Andretta, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

018541 Issued in NY

Practice address

6421 Booth St
Unit 4B
Rego Park, NY 11374-3048

Phone

(516) 994-1630

NPI assigned

May 19, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Stillwater Psychological and Occupational Therapy Assoc PLLC

  • Clinical Psychologist
  • Bay Shore, NY
  • NPI 1982666822
  Medicare reassignment

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274659200000",
    "number": "1124253265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6421 BOOTH ST",
            "address_2": "UNIT 4B",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743048",
            "telephone_number": "516-994-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6421 BOOTH ST",
            "address_2": "UNIT 4B",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743048",
            "telephone_number": "516-994-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRETTA",
        "first_name": "PATRICK",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-19",
        "last_updated": "2010-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "018541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yulian Aminov, DDS
• Eleonora Aminova I, MAED
• Milana Aminova
• Cherie Anderson
• Joseph Pagaoa Andres, P.T.
• Constantine T. Andrew, M.D.
• Joanne Andrews O'Hearn
• Jason B Andrews, CASAC
• Anesthesia Solutions, PC
• Sandra Angelella, RD

• Clinical Psychologist in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.