Peter C Campanelli, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0113661 Issued in NY

Practice address

40 Rector St
New York, NY 10006-1705

Phone

(212) 385-3030

NPI assigned

Apr 10, 2007

Sex

Male

Sole proprietor

No

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 NJ, NY2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Che Senior Psychological Services, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1023078219

  Clinical, NY

  Medicare reassignment NPD
• Knapp Street Psychiatry, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1043248776

  Clinical, NY

  Medicare reassignment NPD
• NJ Behavioral Health Services PC

  • Clinical Psychologist
  • Paramus, NJ
  • NPI 1447289376

  Clinical, NJ

  Medicare reassignment NPD
• Central Neurosurgical Group, P.a.

  • Neurological Surgery Physician
  • New Brunswick, NJ
  • NPI 1639464365
  NPD (past)

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164545489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 AMALIE CT",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077261859",
            "telephone_number": "732-446-5307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 RECTOR ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100061705",
            "telephone_number": "212-385-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPANELLI",
        "first_name": "PETER",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "0113661",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "0215",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Campana
• Gianna Nicole Campanale, PA
• Gina Campanella
• Jamie Campanella, LMSW
• Nicole Marie Campanella I, R.PH.
• Maria Elena Campaner-Cantos, NP
• Francesca Campanile, NP
• Maria Jean Campanile, FNP-BC
• Victor Campano, MD
• McKenna Ray Campbell-Potter

• All providers in New York, NY
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.