Jerry David Duvinsky, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0103631 Issued in NY

Practice address

804 Valley PLZ
Johnson City, NY 13790-1009

Phone

(607) 797-1100

Fax

(607) 797-9514

NPI assigned

Nov 14, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Psychologist

Education

Other, 1991

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jerry Duvinsky PHD Licensed Psychologist PC

  • Clinical Psychologist
  • Endicott, NY
  • NPI 1043684681
  Medicare reassignment NPD Authorized official
• Davenport Holistic Healing and Wellness LLC

  • Clinical Social Worker
  • Spencer, NY
  • NPI 1699590307
  NPD (past)
• Oakdale Psychology Associates

  • Clinical Psychologist
  • Johnson City, NY
  • NPI 1497944318
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265504211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 VALLEY PLZ",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901009",
            "telephone_number": "607-797-1100",
            "fax_number": "607-797-9514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 VALLEY PLZ",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901009",
            "telephone_number": "607-797-1100",
            "fax_number": "607-797-9514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUVINSKY",
        "first_name": "JERRY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "0103631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01409512",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Durham Drace, ATC
• Jacob Dunham, PA
• Karen Lee Dunham, PA
• Wendy Marie Dunn, LCSW
• Brittany Kristen Lee Duran, FNP
• Sarah Catherine Dvorsky, M.A., CCC-SLP
• Philip John Dzwonczyk, MD
• Sarah Eaton, LCSW-R
• Samantha Louise Eckhardt, OTR/L
• Taylor Jane Edgar

• Clinical Psychologist in Johnson City, NY
• Providers in Johnson City, 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 Jul 8, 2007; 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.