Amy Susan Debernardi, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

755 Issued in NM

Practice address

22 St. Anthony Drive
Zuni, NM 87327

Phone

(505) 782-5870

NPI assigned

Feb 18, 2009

Last updated

Feb 18, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Meditelecare of New Mexico, LLC

  • Psychiatry Physician
  • Espanola, NM
  • NPI 1629639729
  Medicare reassignment NPD

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234915200000",
    "number": "1336388198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 HERMIT FALLS DR SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871247285",
            "telephone_number": "505-670-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 ST. ANTHONY DRIVE",
            "city": "ZUNI",
            "state": "NM",
            "postal_code": "87327",
            "telephone_number": "505-782-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBERNARDI",
        "first_name": "AMY",
        "middle_name": "SUSAN",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-18",
        "last_updated": "2009-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NM",
            "license": "755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000N4239",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyla Cheama, BA, LSAA
• Farlan Cooeyate, PA
• Eric Coontz, DDS DENTISTRY
• Johanna Karin Cooper, FNP
• Robert Crooks, MD
• Maya Degroote, MD
• Amy Jo Wayea Doughty, CNM
• Richard Dryer, DDS DENTISTRY
• Jennifer Diane Enote Becker, M.S.CCC-SLP
• Olivia Eriacho, LADAC

• Psychologist in Zuni, NM
• Providers in Zuni, NM by specialty
• Psychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.