Active NPI
William Iaccino, PH.D.
- Clinical Psychologist
- Babylon, NY
National Provider Identifier
1376691469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 014854
- Practice address
- 74 Fire Island Ave
Babylon, NY 11702-3531 - Phone
- (631) 943-5493
- NPI assigned
- Jan 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 014854 | NY | Primary |
Addresses
Primary practice location
74 Fire Island Ave
Babylon, NY 11702-3531
Mailing address
2483 Freeport St
Wantagh, NY 11793-4526
Phone (631) 943-5493
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110621000094 | NY | Practitioner - Clinical Psychologist | 2163488180 | Practice locations: Wantagh, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
74 Fire Is
Wantagh, NY 11793
Phone (631) 943-5493
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482883200000",
"number": "1376691469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2483 FREEPORT ST",
"city": "WANTAGH",
"state": "NY",
"postal_code": "117934526",
"telephone_number": "631-943-5493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74 FIRE ISLAND AVE",
"city": "BABYLON",
"state": "NY",
"postal_code": "117023531",
"telephone_number": "631-943-5493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IACCINO",
"first_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2016-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "014854",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Babylon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; 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.