Andrea Viviana Pellegrini, PSY.D.

Primary specialty

Health Service PsychologistTaxonomy code 103TH0100X

License

PY9304 Issued in FL

Practice address

3589 Canopy Cir
Suite 190
Naples, FL 34120

Phone

(786) 683-9811

NPI assigned

Jul 26, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

State licenses

Practice roles

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.

• Avp Assessment Services, LLC

  • Health Service Psychologist
  • Naples, FL
  • NPI 1407419831
  NPD Authorized official
• Integrative Treatment Options

  dba None

  • Clinical Psychologist
  • Sarasota, FL
  • NPI 1942452198
  NPD (past)
• Pro Performance Physical Therapy LLC

  • Physical Therapist
  • Fort Lauderdale, FL
  • NPI 1215598529
  NPD (past)

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555804800000",
    "number": "1316250889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8688",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341018688",
            "telephone_number": "786-683-9811",
            "fax_number": "800-398-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3589 CANOPY CIR",
            "address_2": "SUITE 190",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "34120",
            "telephone_number": "786-683-9811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 Bailey Ln Ste 200",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341058523",
            "country_code": "US",
            "telephone_number": "239-262-8971",
            "fax_number": "239-262-5903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELLEGRINI",
        "first_name": "ANDREA",
        "middle_name": "VIVIANA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-26",
        "last_updated": "2019-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "33972",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "9304",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "FL",
            "license": "PY9304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PY9304",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pelican Bay Hearing Care, Inc.
• Pelican Bay Retirement Services Inc (Premier Place at the Glenview)
• Pelican Sports & Rehabilitation of Naples
• Pelican Sports and Rehabilitation, Inc
• Joel Charles Pelissier, M.D.
• Melissa Pena Alvarez
• Rodolfo Javier Pena-Ariet, MD
• Manuel M Pena, M.D.
• Priscila Pena
• Judith K Pence, PT

• Health Service Psychologist in Naples, FL
• Providers in Naples, FL by specialty
• Health Service Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.