Michael H Debellis, PSY.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY24336 Issued in CA

Practice address

1838 El Camino Real Ste 100
Burlingame, CA 94010-3105

Phone

(510) 316-4364

NPI assigned

Oct 24, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

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

{
    "created_epoch": "1319414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1154607174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3218 ROOSEVELT AVE",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948041548",
            "telephone_number": "510-316-4364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1838 EL CAMINO REAL STE 100",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103105",
            "telephone_number": "510-316-4364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBELLIS",
        "first_name": "MICHAEL",
        "middle_name": "H",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-24",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY24336",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY24336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael Emily Dawson, LEP
• Kiauna Day-Smith, MS, PPS
• Mary Grace De Castro, MA
• Jenniffer De la Cruz Garrido
• Ajanta De, M.D.
• Debra Shapiro, M.D., Inc.
• Victoria Deguzman
• Krista Ariel Conde Dela Cruz, OTD
• Margaret Delano, M.D.
• Ginger Della Maggiora

• Clinical Neuropsychologist in Burlingame, CA
• Providers in Burlingame, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.