Peter Vietze, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

017065 Issued in NY

Practice address

465 Grand St
3Rd Floor
New York, NY 10002-4800

Phone

(347) 668-4992

Fax

(212) 420-1910

NPI assigned

Feb 27, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

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 2

Specialty

Clinical Psychologist

Education

Other, 1969

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Wellqor Psychological Services Northeast, PC

  • Clinical Psychologist
  • Highland Park, NJ
  • NPI 1326442567

  NY

  Medicare reassignment Authorized official
• Community Assistance Resources & Extended Services Inc

  • Case Management Agency
  • New York, NY
  • NPI 1396049987
  Medicare reassignment NPD
• PM Vietze PHD LLC

  • Clinical Child & Adolescent Psychologist
  • Plainfield, NJ
  • NPI 1548879984
  NPD (past) Authorized official
• Wellqor Psychological Services, PC

  • Clinical Psychologist
  • Melville, NY
  • NPI 1063920841
  NPD
• Federation Employment and Guidance Service, Inc

  • Developmental Disabilities Clinic/Center
  • New York, NY
  • NPI 1942243084
  NPD (past)

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428278400000",
    "number": "1235266016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "957 CEDARBROOK RD",
            "city": "PLAINFIELD",
            "state": "NJ",
            "postal_code": "070602646",
            "telephone_number": "347-668-4992",
            "fax_number": "908-757-8322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 GRAND ST",
            "address_2": "3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100024800",
            "telephone_number": "347-668-4992",
            "fax_number": "212-420-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIETZE",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2015-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "017065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liam John Vierboom, MBBS BSC MHL FRACS
• Susan M Vierczhalek, MD
• Lisa Viergutz
• Toni W. Viertel, L.C.S.W.
• Marisa Viets, AUD
• Yvonne R Vieyra
• Soumya Vig, MD
• Jonathan Matthew Vigdorchik, M.D.
• Robert Vigil, CASAC
• Nicholas Francis Vigilante III, MD

• Clinical Child & Adolescent Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Child & Adolescent Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2015; 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.

Verify at the official NPI Registry.