Individual provider Active NPI

John J Bowman, PH.D.

  • Psychologist
  • Port Jefferson Station, NY
National Provider Identifier
1306943717
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5893 Issued in NY
Practice address
5225 Nesconset Hwy Ste 49
Port Jefferson Station, NY 11776-2060
Phone
(631) 331-7857
Fax
(631) 476-4624
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 5893 NY Primary

Addresses

Primary practice location

5225 Nesconset Hwy Ste 49
Port Jefferson Station, NY 11776-2060

Mailing address

71 Saddle Rock Rd
East Setauket, NY 11733-1829
Phone (631) 751-5807

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
I20120501000223 NY Practitioner - Clinical Psychologist 0648432005 Practice locations: East Setauket, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

71 Saddle Rock Rd
East Setauket, NY 11733-1829
Phone (631) 331-7857

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5893NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Steven J Litman MD PC Past Accepting new patients

Organizations & group practices 1

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306943717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 SADDLE ROCK RD",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117331829",
            "telephone_number": "631-751-5807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 NESCONSET HWY STE 49",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762060",
            "telephone_number": "631-331-7857",
            "fax_number": "631-476-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "5893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

Verify at the official NPI Registry.