Nicholas Desisto

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

615 Hope Rd Ste 3B
Eatontown, NJ 07724-1273

Phone

(732) 724-1234

NPI assigned

Nov 7, 2021

Last updated

Nov 7, 2021By the provider in NPPES

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

Enrolled in NJ

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

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Mental and Behavioral Services, IncGroup PAC ID 6305240912, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Premier Mental & Behavioral Services, Inc

  dba Positive Reset Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Eatontown, NJ
  • NPI 1114599305
  Medicare reassignment Care Compare group NPD
• Premier Mental & Behavioral Services, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brick, NJ
  • NPI 1649958372
  NPD

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

{
    "created_epoch": "1636243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636243200000",
    "number": "1487319158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 ALESSIO TER",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086209772",
            "telephone_number": "609-477-8557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 HOPE RD STE 3B",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241273",
            "telephone_number": "732-724-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Cornwall Ct Ste B",
            "address_purpose": "LOCATION",
            "city": "East Brunswick",
            "state": "NJ",
            "postal_code": "088163347",
            "country_code": "US",
            "telephone_number": "732-955-4141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESISTO",
        "first_name": "NICHOLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-07",
        "last_updated": "2021-11-07",
        "certification_date": "2021-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Metin Bera Talha Demirci, M.D.
• Mia Depalma
• Natasha Desai
• Casey Desarno, OT
• Stephanie Concetta Desimone, PA-C
• Rebecca Desousa
• Alexandra Devito, MSW, LCSW
• Sukhreet Dhillon, PHARMD
• Diabetes Education and Wellness
• Nicole Marie Dibello, PHARMD

• Professional Counselor in Eatontown, NJ
• Providers in Eatontown, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2021; 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.