Peter Paul Tolisano Jr., PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2993 Issued in CT

Practice address

68 S Main St Ste 200
West Hartford, CT 06107-2445

Phone

(860) 778-4942

NPI assigned

Apr 19, 2007

Sex

Male

Sole proprietor

Yes

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

Enrolled in CT

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

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Peter Tolisano PSYD LLC

  • Community/Behavioral Health Agency
  • West Hartford, CT
  • NPI 1811379662
  Medicare reassignment NPD Authorized official
• Applied Behavioral Sciences LLC

  • Clinical Psychologist
  • West Hartford, CT
  • NPI 1386782977
  NPD (past)

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1356568851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DEKOVEN DR APT 1202",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573465",
            "telephone_number": "860-778-4942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 S MAIN ST STE 200",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072445",
            "telephone_number": "860-778-4942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLISANO",
        "first_name": "PETER",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "2993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.