John P Vicedomini, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0129651 Issued in NY

Practice address

1286 Shaw PL
Seaford, NY 11783-1747

Phone

(516) 221-2032

NPI assigned

Dec 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mr. John P Vicedomini Professional name

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

University of Kentucky College of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Metropolitan Psychological & Licensed Master Social Work Services PLLC

  • Clinical Psychologist
  • Bay Shore, NY
  • NPI 1891833588
  NPD (past)

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315526400000",
    "number": "1487630877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1286 SHAW PL",
            "city": "SEAFORD",
            "state": "NY",
            "postal_code": "117831747",
            "telephone_number": "516-221-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1286 SHAW PL",
            "city": "SEAFORD",
            "state": "NY",
            "postal_code": "117831747",
            "telephone_number": "516-221-2032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICEDOMINI",
        "first_name": "JOHN",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2011-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "0129651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01767748",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "VICEDOMINI",
            "middle_name": "P",
            "prefix": "MR.",
            "credential": "PHD PLLC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Linda Vassilio
• Vcare RX Pharmacy LLC
• Vcare RX Pharmacy LLC
• Jenna Ann Venditto
• Sabrina Verdi
• Marina Vidovic, FNP
• Kristin Viets
• Viktoriya Vinokur
• Joseph Anthony Violano Jr.
• Nicole Marie Viscusi, MS CCC-SLP

• Clinical Psychologist in Seaford, NY
• Providers in Seaford, 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 Sep 9, 2011; 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.