Active NPI
Andreas Costas Michaelides, PH.D.
- Psychologist
- Smithtown, NY
National Provider Identifier
1215245220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 373 Route 111
Suite 10
Smithtown, NY 11787-4759 - Phone
- (631) 540-3030
- NPI assigned
- Sep 24, 2010
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
373 Route 111
Suite 10
Smithtown, NY 11787-4759
Mailing address
373 Route 111
Suite 10
Smithtown, NY 11787-4759
Phone (631) 240-3030
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418169600000",
"number": "1215245220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "373 ROUTE 111",
"address_2": "SUITE 10",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117874759",
"telephone_number": "631-240-3030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "373 ROUTE 111",
"address_2": "SUITE 10",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117874759",
"telephone_number": "631-540-3030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHAELIDES",
"first_name": "ANDREAS",
"middle_name": "COSTAS",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-24",
"last_updated": "2014-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smithtown, NY
- Robert H Meyer, PHD
- Joel L. Meyers, P.T., DPT
- Michael a Herships Psychologist, PC
- Michael Bishai MD, LLC
- Michael Derosa NP Adult Health PC
- Maria A. Michalski, O.D.
- Cristina Michelcic, SPECIAL ED TEACHER
- Michele Ahmadi D.P.M. L.L.C.
- Michelle Eckhoff, Marriage and Family Therapist, PLLC
- Mid-Suffolk Neurosurgical Associates, PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.