David M Bortnick, PHD PSYD ABN

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PY2065 Issued in FL

Practice address

1750 Tree Blvd Ste 5
St Augustine, FL 32084-5719

Phone

(904) 342-0672

Fax

(904) 342-0673

NPI assigned

Apr 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Dr. Steven P. Dingfelder & Assoc., Inc.

  • Clinical Psychologist
  • St. Augustine, FL
  • NPI 1609886696
  NPD (past)

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

{
    "created_epoch": "1146355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1356308530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3123",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320853123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 TREE BLVD STE 5",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320845719",
            "telephone_number": "904-342-0672",
            "fax_number": "904-342-0673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORTNICK",
        "first_name": "DAVID",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD PSYD ABN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-30",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY2065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eliane Guerreiro de Borba, M. ED., BCBA
• Bernard R Borbely, MD
• Borges DMD PLLC
• Olamide O Borisade, MSN, APRN, PMHNP-BC
• Claudia Borrero
• Jack Bosma, PT, DPT, CSCS
• Cody Bryan Boswell, DC
• Hugo Botero, DPT
• Leiane Moore Boudreau, ARNP
• Luis J Boulier, COTA

• Clinical Neuropsychologist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Clinical Neuropsychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; 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.