Individual provider Active NPI

Joel D Shuy, PSY.D

  • Clinical Psychologist
  • Cocoa, FL
National Provider Identifier
1164572574
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY0005480 Issued in FL
Practice address
96 Willard St
Suite 306
Cocoa, FL 32922-7991
Phone
(321) 638-0027
Fax
(321) 638-0115
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

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 PY0005480 FL Primary

Addresses

Primary practice location

96 Willard St
Suite 306
Cocoa, FL 32922-7991

Mailing address

96 Willard St
Suite 306
Cocoa, FL 32922-7991
Phone (321) 638-0027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20111220000447 FL Practitioner - Clinical Psychologist 4385810498 Reassigns benefits to 1 organization
Practice locations: Palm Bay, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Atlantic Psychiatric Centers IncGroup PAC ID 1557357860, 23 clinicians

Practice addresses (Care Compare)

2123 Franklin Dr NE
Palm Bay, FL 32905-4022
Phone (321) 724-1614

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY0005480FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Psychiatric Centers, Inc. Clinical CurrentSince Oct 8, 2011 Accepting new patients

Locations

2123 Franklin Dr NE
Palm Bay, FL 32905
Phone (321) 724-1614

4185 US Highway 1
Ste 102
Rockledge, FL 32955
Phone (321) 638-0027

Interoperability endpoints

  • Direct secure messaging: atlanticpsychiatric.joelshuy@157402.advancedmd-direct.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1164572574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 WILLARD ST",
            "address_2": "SUITE 306",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227991",
            "telephone_number": "321-638-0027",
            "fax_number": "321-638-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 WILLARD ST",
            "address_2": "SUITE 306",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227991",
            "telephone_number": "321-638-0027",
            "fax_number": "321-638-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUY",
        "first_name": "JOEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY0005480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa, FL

Sources for this page

Verify at the official NPI Registry.