Michael Femenella, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

013369 Issued in NY

Practice address

279 Suffolk Ave
Staten Island, NY 10314-6948

Phone

(718) 983-0633

Fax

(718) 983-0348

NPI assigned

Jul 1, 2006

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 1, 2018 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396774576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 NORTH CRES",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070402707",
            "telephone_number": "718-983-0633",
            "fax_number": "718-983-0348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 SUFFOLK AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146948",
            "telephone_number": "718-983-0633",
            "fax_number": "718-983-0348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEMENELLA",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "013369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard S Felix, M.D.
• Victoria Felix, PH.D.
• Karen G. Felton-Handley, LCSW
• Jessica Felton
• Yisrael Feman, DO
• Inemesit Femi Adegbulu
• Nicole J Femiano
• Trinity Fenga
• Robin E Fenley, PHD, LCSW
• Fennec Performan LLC

• Clinical Psychologist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.