Individual provider Active NPI

Stephen Pappalardo, PHD

  • Clinical Psychologist
  • West Hartford, CT
National Provider Identifier
1124738521
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4313 Issued in CT
Practice address
10 N Main St Ste 1
West Hartford, CT 06107-1968
Phone
(860) 519-5227
NPI assigned
Nov 28, 2022
Last updated
Nov 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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 4313 CT Primary

Addresses

Primary practice location

10 N Main St Ste 1
West Hartford, CT 06107-1968

Mailing address

10 N Main St Ste 1
West Hartford, CT 06107-1968
Phone (860) 519-5227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20221221002572 CT Practitioner - Clinical Psychologist 8426428178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin D. Oliveira Psy D LLCGroup PAC ID 4385931195, 5 clinicians

Practice addresses (Care Compare)

10 N Main St
Suite 1
West Hartford, CT 06107-1968
Phone (860) 519-5227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Martin D Oliveira Psy D LLC CurrentSince Oct 1, 2022 Accepting new patients

Locations

10 N Main St
Ste 1
West Hartford, CT 06107
Phone (860) 415-6463

15 N Main St
Ste 100
West Hartford, CT 06107
Phone (214) 532-3757

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, 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": "1669593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1124738521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 N MAIN ST STE 1",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071968",
            "telephone_number": "860-519-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N MAIN ST STE 1",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071968",
            "telephone_number": "860-519-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPPALARDO",
        "first_name": "STEPHEN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-28",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "4313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.