Individual provider Active NPI

Laura A. Pontrelli, PHD

  • Clinical Psychologist
  • Sleepy Hollow, NY
National Provider Identifier
1225190374
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
012770-1 Issued in NY
Practice address
239 N Broadway Ste 1
Sleepy Hollow, NY 10591-2654
Phone
(914) 332-1769
Fax
(914) 332-1769
NPI assigned
Dec 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 012770-1 NY Primary

Addresses

Primary practice location

239 N Broadway Ste 1
Sleepy Hollow, NY 10591-2654

Mailing address

239 N Broadway Ste 1
Sleepy Hollow, NY 10591-2654
Phone (914) 332-1769

Other identifiers 6

IdentifierTypeStateIssuer
285076OtherNYMHN
V83711OtherNYEMPIRE BLUE CROSS
012770-4OtherNYWORKERS COMP
0007994429OtherNYAETNA
6135269OtherNYUNITED BEHAVIORAL HEALTH
P2126970OtherNYOXFORD

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180222000835 NY Practitioner - Clinical Psychologist 5294625315 Practice locations: Croton on Hudson, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1392 Albany Post Rd
Suite 2C
Croton on Hudson, NY 10520-1560
Phone (914) 332-1769

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
012770-1NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225190374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 N BROADWAY STE 1",
            "city": "SLEEPY HOLLOW",
            "state": "NY",
            "postal_code": "105912654",
            "telephone_number": "914-332-1769",
            "fax_number": "914-332-1769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 N BROADWAY STE 1",
            "city": "SLEEPY HOLLOW",
            "state": "NY",
            "postal_code": "105912654",
            "telephone_number": "914-332-1769",
            "fax_number": "914-332-1769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONTRELLI",
        "first_name": "LAURA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "012770-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "285076",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS",
            "identifier": "V83711",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP",
            "identifier": "012770-4",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007994429",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "6135269",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2126970",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sleepy Hollow, NY

Sources for this page

Verify at the official NPI Registry.