Individual provider Active NPI

Veronique Regina Deutsch-Anzalone, PSYD

  • Clinical Psychologist
  • Stony Brook, NY
National Provider Identifier
1124338017
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
019480 Issued in NY
Practice address
100 Nicolls Rd Dept of
Stony Brook, NY 11794-0012
Phone
(631) 632-2428
NPI assigned
Oct 14, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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 019480 NY Primary

Addresses

Primary practice location

100 Nicolls Rd Dept of
Stony Brook, NY 11794-0012

Mailing address

100 Nicolls Rd Dept of
Stony Brook, NY 11794-0012
Phone (631) 632-2428

Other practice location 1

35 Longwood Road
Just Kids
Middle Island, NY 11953-2045
Phone (631) 924-0008

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
I20201019002694 NY Practitioner - Clinical Psychologist 8628498326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

169 Putnam Hall
South Campus
Stony Brook, NY 11794-8790
Phone (631) 632-8850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019480NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Psychiatric Associates, University Faculty Practice Corpor CurrentSince Jun 12, 2020 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients

Locations

169 Putnam Hall
Stony Brook, NY 11794
Phone (631) 632-8850

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: veronique.deutschanzalone@direct.stonybrookmedicine.edu

Organizations & group practices 2

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": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1124338017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NICOLLS RD DEPT OF",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940012",
            "telephone_number": "631-632-2428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NICOLLS RD DEPT OF",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940012",
            "telephone_number": "631-632-2428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Longwood Road",
            "address_2": "Just Kids",
            "address_purpose": "LOCATION",
            "city": "Middle Island",
            "state": "NY",
            "postal_code": "119532045",
            "country_code": "US",
            "telephone_number": "631-924-0008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEUTSCH-ANZALONE",
        "first_name": "VERONIQUE",
        "middle_name": "REGINA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-14",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.