Individual provider Active NPI

Nicola Giordano, PSY.D

  • Clinical Psychologist
  • Hamden, CT
National Provider Identifier
1225216880
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
002904 Issued in CT
Practice address
3074 Whitney Avenue, Building 1
Hamden, CT 06518-2324
Phone
(203) 936-8697
NPI assigned
Feb 6, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 048-0000915 VT
Clinical Psychologist 103TC0700X 002904 CT Primary

Addresses

Primary practice location

3074 Whitney Avenue, Building 1
Hamden, CT 06518-2324

Mailing address

33 Anthony CT
Bethany, CT 06524-3226
Phone (802) 683-1540

Other identifiers 2

IdentifierTypeStateIssuer
1225216880MedicaidCT
446545OtherCTMHN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20090615000199 CT Practitioner - Clinical Psychologist 1557446929 Reassigns benefits to 1 organization
Practice locations: Bethany, CT; Hamden, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Illinois Medical College, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Harvest Healthcare LLCGroup PAC ID 9931276979, 72 clinicians

Practice addresses (Care Compare)

21 Waterville Rd
Avon, CT 06001-2097
Phone (860) 284-0182

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
048-0000915VTMDClinical Psychologist
2904CTMDSocial Worker
002904CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harvest Healthcare LLC CurrentSince May 3, 2021 Accepting new patients
Deer Oaks New England, LLC Clinical Past Accepting new patients
Deer Oaks Mental Health Associates PC Clinical Past Accepting new patients

Locations

21 Waterville Rd
Avon, CT 06001
Phone (860) 284-0182

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1225216880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 ANTHONY CT",
            "city": "BETHANY",
            "state": "CT",
            "postal_code": "065243226",
            "telephone_number": "802-683-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3074 WHITNEY AVENUE, BUILDING 1",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065182324",
            "telephone_number": "203-936-8697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIORDANO",
        "first_name": "NICOLA",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-06",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "048-0000915",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225216880",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "446545",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

Verify at the official NPI Registry.