Active NPI
Wendy Barbara Doret, PH.D.
- Psychologist
- Dix Hills, NY
National Provider Identifier
1194866137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6257
- Practice address
- 49 Fairfield Dr
Dix Hills, NY 11746-7162 - Phone
- (631) 243-6528
- Fax
- (631) 243-6387
- NPI assigned
- Feb 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6257 | NY | Primary |
Addresses
Primary practice location
49 Fairfield Dr
Dix Hills, NY 11746-7162
Mailing address
49 Fairfield Dr
Dix Hills, NY 11746-7162
Phone (631) 243-6528
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00747695 | Medicaid | NY |
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 |
|---|---|---|---|
| 6257 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194866137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49 FAIRFIELD DR",
"city": "DIX HILLS",
"state": "NY",
"postal_code": "117467162",
"telephone_number": "631-243-6528",
"fax_number": "631-243-6387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "49 FAIRFIELD DR",
"city": "DIX HILLS",
"state": "NY",
"postal_code": "117467162",
"telephone_number": "631-243-6528",
"fax_number": "631-243-6387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORET",
"first_name": "WENDY",
"middle_name": "BARBARA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "6257",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00747695",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dix Hills, NY
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.