Active NPI
Patrick T Collins, PHD
- Clinical Psychologist
- Port Jeffeson Station, NY
National Provider Identifier
1194806422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0049481
- Practice address
- 5225 46 Route 347
Building 8 10
Port Jeffeson Station, NY 11776 - Phone
- (631) 928-5071
- Fax
- (631) 928-4784
- NPI assigned
- Oct 17, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0049481 | NY | Primary |
Addresses
Primary practice location
5225 46 Route 347
Building 8 10
Port Jeffeson Station, NY 11776
Mailing address
5225 46 Route 347
Building 8 10
Port Jeffeson Station, NY 11776
Phone (631) 928-5071
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0049481 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194806422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5225 46 ROUTE 347",
"address_2": "BUILDING 8 10",
"city": "PORT JEFFESON STATION",
"state": "NY",
"postal_code": "11776",
"telephone_number": "631-928-5071",
"fax_number": "631-928-4784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5225 46 ROUTE 347",
"address_2": "BUILDING 8 10",
"city": "PORT JEFFESON STATION",
"state": "NY",
"postal_code": "11776",
"telephone_number": "631-928-5071",
"fax_number": "631-928-4784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "PATRICK",
"middle_name": "T",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "0049481",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- 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.