Active NPI
Susan Elizabeth D'Ambrosio, PSY.D.
- Clinical Psychologist
- Hartford, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 002626
- Practice address
- 79 Retreat Avenue
Hartford Hospital Psychiatry Dept
Hartford, CT 06106-2527 - Phone
- (860) 972-0200
- NPI assigned
- Jun 22, 2006
- Sex
- Female
- 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 | 002626 | CT | Primary |
Addresses
Primary practice location
79 Retreat Avenue
Hartford Hospital Psychiatry Dept
Hartford, CT 06106-2527
Mailing address
79 Retreat Avenue
Hartford Hospital Psychiatry Dept
Hartford, CT 06106-2527
Phone (860) 972-0200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008026262 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
79 Retreat Ave
Hartford, CT 06106-2527
Phone (860) 972-7182
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.42 of 100
- Quality
- 83.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.9
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002626 | CT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bio Behavioral Psychology P.C. | Clinical | Current | Accepting new patients |
| Hartford Pathology Associates, P.C. | Current | Accepting new patients | |
| Hartford Healthcare Medical Group Specialists LLC | Current | Accepting new patients | |
| Hartford Healthcare Medical Group Specialists, PLLC | Current | Accepting new patients | |
| Hartford Healthcare Medical Group, Inc | Current | Accepting new patients | |
| Knapp Street Psychiatry, PC | Clinical | Current | Accepting new patients |
| Hartford Hospital | Current | Accepting new patients | |
| Che Senior Psychological Services, PC | Clinical | Current | Accepting new patients |
Locations
79 Retreat Ave
Hartford, CT 06106
Phone (860) 545-0200
55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144
1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579
1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700
250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212
935 Northern Blvd
Ste 102
Great Neck, NY 11021
Phone (516) 487-7116
100 Park Ave
Fl 16
New York, NY 10017
Phone (212) 433-2384
209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625
135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101
Interoperability endpoints
- susan.dambrosio@xdr.hhchealthdirect.org
Organizations & group practices 9
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.
-
- Surgery Physician
- Hartford, CT
- NPI 1023584216
-
- Surgery Physician
- Wethersfield, CT
- NPI 1043561301
-
- Clinical Psychologist
- Great Neck, NY
- NPI 1063659555
-
- Clinical Psychologist
- Brooklyn, NY
- NPI 1023078219
-
- Clinical Psychologist
- Brooklyn, NY
- NPI 1043248776
-
- General Acute Care Hospital
- Hartford, CT
- NPI 1770696643
-
- Customized Equipment (DME)
- Groton, CT
- NPI 1295367068
-
- General Acute Care Hospital
- Hartford, CT
- NPI 1902834880
-
- Anatomic Pathology & Clinical Pathology Physician
- Hartford, CT
- NPI 1063464477
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477958400000",
"number": "1225074420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 RETREAT AVENUE",
"address_2": "HARTFORD HOSPITAL PSYCHIATRY DEPT",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061062527",
"telephone_number": "860-972-0200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79 RETREAT AVENUE",
"address_2": "HARTFORD HOSPITAL PSYCHIATRY DEPT",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061062527",
"telephone_number": "860-972-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "D'AMBROSIO",
"first_name": "SUSAN",
"middle_name": "ELIZABETH",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-22",
"last_updated": "2016-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "002626",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008026262",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.