Jesse A Siegel, PSYD, LP

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

6049 Issued in NC

Practice address

3310 Croasdaile Dr Ste 400
Durham, NC 27705-6806

Phone

(919) 384-9682

NPI assigned

Jun 25, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Triangle Neuropsychology Services, PLLCGroup PAC ID 3173522901, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Triangle Neuropsychology Services, PLLC

  • Clinical Neuropsychologist
  • Durham, NC
  • NPI 1689625386
  Medicare reassignment Care Compare group NPD
• Dr. Mary Berge and Associates, LLC

  • Community/Behavioral Health Agency
  • Johnstown, PA
  • NPI 1063783678
  NPD (past)

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

{
    "created_epoch": "1498348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1467972000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 CROASDAILE DR STE 400",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277056806",
            "telephone_number": "919-384-9682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 CROASDAILE DR STE 400",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277056806",
            "telephone_number": "919-384-9682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1540 Sunday Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276076010",
            "country_code": "US",
            "telephone_number": "919-384-9682",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "JESSE",
        "middle_name": "A",
        "credential": "PSYD, LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-25",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NC",
            "license": "6049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wajiha Tariq Siddiqui, DMD
• Navjeet Kaur Sidhu-Malik, M.D.
• Aranjeet Sidhu, PHARMD
• Kulbir K Sidhu, M.D.
• Daria Siegel, LPCA, MS
• Rachel Rebecca Siegel, MSW
• Leslie Sierra-Arevalo
• Tara Lynn Siesel, ATC
• Lauren Elizabeth Siewny
• Kena B Sigman, CRNA

• Clinical Neuropsychologist in Durham, NC
• Providers in Durham, NC by specialty
• Clinical Neuropsychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.