Individual provider Active NPI

Alyssa Nicole De Vito-Izzo, PHD

  • Clinical Neuropsychologist
  • Providence, RI
National Provider Identifier
1336015445
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PS02346 Issued in RI
Practice address
345 Blackstone Blvd
Providence, RI 02906-4800
Phone
(401) 455-6200
Fax
(401) 455-6689
NPI assigned
Oct 15, 2025
Last updated
Oct 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PS02346 RI Primary

Addresses

Primary practice location

345 Blackstone Blvd
Providence, RI 02906-4800

Mailing address

455 Toll Gate Road
PRC and Credentialing
Warwick, RI 02886-2759
Phone (401) 273-0641

Other names 1

  • Alyssa De Vito Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20251105000740 RI Practitioner - Clinical Psychologist 1254821663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

455 Toll Gate Rd
Warwick, RI 02886-2759

455 Toll Gate Rd
Warwick, RI 02886-2770

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS02346RIMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Dec 21, 2025 Accepting new patients
Affinity Physicians LLC. Clinical Neuropsychologist Past Accepting new patients

Locations

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1760486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1336015445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE ROAD",
            "address_2": "PRC AND CREDENTIALING",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-273-0641",
            "fax_number": "401-273-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 BLACKSTONE BLVD",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064800",
            "telephone_number": "401-455-6200",
            "fax_number": "401-455-6689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE VITO-IZZO",
        "first_name": "ALYSSA",
        "middle_name": "NICOLE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-15",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "RI",
            "license": "PS02346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "DE VITO",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.