Individual provider Active NPI

Donna M Chimera, PH.D.

  • Clinical Psychologist
  • North Baldwin, NY
National Provider Identifier
1285653691
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
9297 Issued in NY
Practice address
3 Spruce CT
North Baldwin, NY 11510-2745
Phone
(516) 377-3345
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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 9297 NY Primary

Addresses

Primary practice location

3 Spruce CT
North Baldwin, NY 11510-2745

Mailing address

3 Spruce CT
North Baldwin, NY 11510-2745
Phone (516) 377-3345

Other identifiers 1

IdentifierTypeStateIssuer
0013512OtherNYVALUE OPTIONS - GHI

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
I20040602001207 NY Practitioner - Clinical Psychologist 2062494222 Practice locations: Freeport, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

31 Casino St
Apt 2I
Freeport, NY 11520-5302
Phone (516) 521-9307

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9297NYMDClinical Psychologist
009297NYMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202688000000",
    "number": "1285653691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SPRUCE CT",
            "city": "NORTH BALDWIN",
            "state": "NY",
            "postal_code": "115102745",
            "telephone_number": "516-377-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SPRUCE CT",
            "city": "NORTH BALDWIN",
            "state": "NY",
            "postal_code": "115102745",
            "telephone_number": "516-377-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIMERA",
        "first_name": "DONNA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2008-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "9297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS - GHI",
            "identifier": "0013512",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Baldwin, NY

Sources for this page

Verify at the official NPI Registry.