Amy C. Dittler, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F402005 Issued in NY

Practice address

450 Waverly Ave
Ste 11
Patchogue, NY 11772-1555

Phone

(917) 385-9195

NPI assigned

May 20, 2010

Last updated

Mar 25, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Amy C. Macchia Former name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Aldad Medical PCGroup PAC ID 9234291436, 78 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Aldad Medical PC

  • Psychiatry Physician
  • Ann Arbor, MI
  • NPI 1174784953

  NY

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1274313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1366761009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 AUBORN AVE",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119671734",
            "telephone_number": "917-385-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 WAVERLY AVE",
            "address_2": "STE 11",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721555",
            "telephone_number": "917-385-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTLER",
        "first_name": "AMY",
        "middle_name": "C.",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-20",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "639551",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F402005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "MACCHIA",
            "middle_name": "C.",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Troy E Dickinson, DO
• Marie Christine Didonato, PMHNP
• Natalie M Digioia, MD
• Stacey Ann Dimitriou-Ciaccio, RPA C
• Discoveries Therapy LCSW, P.C.
• Nicole Marie Divirgilio, PT
• DME Medical Supplies Inc.
• Daphnie Doirin, SLP-CCC
• Vanessa Dominique
• Mara Dooley, NP

• Psychiatric/Mental Health Nurse Practitioner in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; 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.