Active NPI
William Calabrese
- Clinical Psychologist
- Stony Brook, NY
National Provider Identifier
1487054367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 023288
- Practice address
- 169 Putnam Hall
Stony Brook, NY 11794-2512 - Phone
- (631) 632-8657
- NPI assigned
- Aug 28, 2014
- Reactivated
- Jan 29, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 023288 | NY | Primary |
| Mental Health Counselor | 101YM0800X |
Addresses
Primary practice location
169 Putnam Hall
Stony Brook, NY 11794-2512
Mailing address
PO Box 1559
Stony Brook, NY 11790-0989
Other practice location 1
14025 SW Farmington Rd
Suite 200
Beaverton, OR 97005-2512
Phone (503) 644-2545
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
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
169 Putnam Hall
South Campus
Stony Brook, NY 11794-8790
Phone (631) 632-8850
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 023288 | NY | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Hospital at Stony Brook | Current | Accepting new patients | |
| Stony Brook Psychiatric Associates, University Faculty Practice Corpor | Current | Accepting new patients |
Locations
169 Putnam Hall
Stony Brook, NY 11794
Phone (631) 632-8850
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
Interoperability endpoints
- william.calabrese@direct.stonybrookmedicine.edu
Organizations & group practices 2
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.
-
- Psychiatry Physician
- Stony Brook, NY
- NPI 1437105905
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598918400000",
"number": "1487054367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1559",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117900989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 PUTNAM HALL",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117942512",
"telephone_number": "631-632-8657"
}
],
"practiceLocations": [
{
"address_1": "14025 SW Farmington Rd",
"address_2": "Suite 200",
"address_purpose": "LOCATION",
"city": "Beaverton",
"state": "OR",
"postal_code": "970052512",
"country_code": "US",
"telephone_number": "503-644-2545",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CALABRESE",
"first_name": "WILLIAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-28",
"last_updated": "2020-09-01",
"certification_date": "2020-09-01",
"deactivation_date": "2019-07-23",
"reactivation_date": "2020-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "023288",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stony Brook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.