Elisabeth R Fonseca, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

013336-1 Issued in NY

Practice address

276 5TH Ave
Suite 1101
New York, NY 10001-4509

Phone

(212) 683-3339

NPI assigned

Feb 5, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 22, 2026 through Jun 22, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423094400000",
    "number": "1245621754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 5TH AVE",
            "address_2": "SUITE 1101",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014509",
            "telephone_number": "212-683-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 5TH AVE",
            "address_2": "SUITE 1101",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014509",
            "telephone_number": "212-683-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONSECA",
        "first_name": "ELISABETH",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-05",
        "last_updated": "2015-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "013336-1",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9868",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pascaline Fonji, RPH, PHARMD
• Ngoanu Empero Fonkem
• Surgein I Fonollosa, LMSW
• Maria Camila Fonseca Mora, MD
• Amanda Fonseca, COTA/L
• Jillian Marie Fonseca, M.S. CCC-SLP
• Jose Luis Fonseca, CRPA-P
• Juan Pablo Fonseca, M. D.
• Victoria Isabella Fonseca
• Valeria Eugenia Font Zorrilla

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.