Portia Lucille Pieterse, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

018848 Issued in NY

Practice address

25 Hackett Blvd
2ND Floor
Albany, NY 12208-3462

Phone

(518) 262-5511

Fax

(518) 262-7035

NPI assigned

Oct 13, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ppieterse28435@albanymed.direct-ci.com

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.

• Albany Medical College

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1497921688
  Medicare reassignment Care Compare group NPD
• Albany Medical College

  dba Albany Med EmUrgent Care

  • Urgent Care Clinic/Center
  • Albany, NY
  • NPI 1386038925
  NPD
• Albany Medical College

  dba Albany Medical College Dept of Psychiatry

  • Psychiatry Physician
  • Albany, NY
  • NPI 1447284328
  NPD
• Albany Medical College

  dba Albany Medical College Department of Medicine

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1386689248
  NPD (past)

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1194035030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 HACKETT BLVD",
            "address_2": "2ND FLOOR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083462",
            "telephone_number": "518-262-5511",
            "fax_number": "518-262-7035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 HACKETT BLVD",
            "address_2": "2ND FLOOR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083462",
            "telephone_number": "518-262-5511",
            "fax_number": "518-262-7035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETERSE",
        "first_name": "PORTIA",
        "middle_name": "LUCILLE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-13",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "018848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald M. Pierce
• Linda Pierre
• Melanie Pierre, LMSW
• Noah Pierzchajlo, MD
• Alex L. Pieterse, PHD
• Donna Marie Pietrocola, M.D.
• Heidi Anne Pietsch, OTR
• Mandi Pigliavento, LCSW
• Vanessa Lee Pike Denning, MD
• Elizabeth Pilinko, RDN

• Clinical Psychologist in Albany, NY
• Providers in Albany, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; 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.