Individual provider Active NPI

Maria Viera Nodarse, PSID

  • School Psychologist
  • Mount Dora, FL
National Provider Identifier
1376811893
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
SS581 Issued in FL
Practice address
2110 N Donnelly St Ste 109
Mount Dora, FL 32757-6969
Phone
(352) 321-0098
NPI assigned
Dec 12, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X SS581 FL Primary

Addresses

Primary practice location

2110 N Donnelly St Ste 109
Mount Dora, FL 32757-6969

Mailing address

2110 North Donnelly Street , Suite 109
Mount Dora, FL 32757-6966
Phone (352) 321-0098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20191209000509 FL Practitioner - Clinical Psychologist 2961787007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1175 Lucerne Dr
Mount Dora, FL 32757-3639
Phone (352) 630-0373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SS581FLMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Maria V. Nodarse, Psy. D., Inc CurrentSince Apr 1, 2020 Accepting new patients

Locations

1175 Lucerne Dr
Mount Dora, FL 32757
Phone (352) 223-8148

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1376811893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 NORTH DONNELLY STREET , SUITE 109",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576966",
            "telephone_number": "352-321-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 N DONNELLY ST STE 109",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576969",
            "telephone_number": "352-321-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NODARSE",
        "first_name": "MARIA",
        "middle_name": "VIERA",
        "name_prefix": "Dr.",
        "credential": "PSID",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-12",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "FL",
            "license": "SS581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Dora, FL

Sources for this page

Verify at the official NPI Registry.