Melissa Pencille, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

021664 Issued in NY

Practice address

450 Clarkson Ave
Brooklyn, NY 11203-2012

Phone

(718) 270-1808

NPI assigned

Jan 23, 2017

Sex

Female

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 NY

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University Physicians of Brooklyn, Inc.Group PAC ID 0749192284, 174 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: melissapencille@sunydmc.allscriptsdirect.net

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.

• University Physicians of Brooklyn, Inc.

  • Family Medicine Physician
  • Brooklyn, NY
  • NPI 1366506271
  Medicare reassignment Care Compare group NPD
• University Physicians of Brooklyn

  dba Downstate Health Physicians

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1558318006
  NPD
• University Physicians of Brooklyn, Inc.

  dba Downstate Health Physicians

  • Child & Adolescent Psychiatry Physician
  • Brooklyn, NY
  • NPI 1689715476

  Psychologist

  NPD

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1407393952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 GARFIELD PL",
            "address_2": "APT 3E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112152100",
            "telephone_number": "516-220-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENCILLE",
        "first_name": "MELISSA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-23",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "021664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priscilla Pena
• Richard Pena, PT
• Vickiana Pena
• Alice Pencavel
• Atoyia Antoinette Pencil, R.N.
• Gianna Frances Pendergast
• Isabella Anna Pendergast
• Kristen Elizabeth Pendergast, PHARMD
• Mackenzie Ellis Pendergast, LMSW
• William Pendergast

• Psychologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.