Individual provider Active NPI

Desiree Romaguera, PSY.D.

  • Clinical Psychologist
  • Bay Shore, NY
National Provider Identifier
1316340490
Registry record updated Oct 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
020821 Issued in NY
Practice address
132 E Main St
Bay Shore, NY 11706-8302
Phone
(631) 647-2530
NPI assigned
Oct 2, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2014

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 020821 NY Primary

Addresses

Primary practice location

132 E Main St
Bay Shore, NY 11706-8302

Mailing address

132 E Main St
Bay Shore, NY 11706-8302
Phone (631) 647-2530

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
I20160111001222 NY Practitioner - Clinical Psychologist 8426350265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

132 E Main St
Bay Shore, NY 11706-8302
Phone (631) 647-2530

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
020821NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Oct 31, 2015 Accepting new patients

Locations

132 E Main St
Bay Shore, NY 11706
Phone (516) 697-2042

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: desireeromaguera@nslijmedgr.allscriptsdirect.net

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": "1412208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1316340490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068302",
            "telephone_number": "631-647-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068302",
            "telephone_number": "631-647-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAGUERA",
        "first_name": "DESIREE",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-02",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "020821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.