Individual provider Active NPI

Teresa M Picciocchi, PSYD

  • Clinical Psychologist
  • Gainesville, FL
National Provider Identifier
1508887696
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY7228 Issued in FL
Practice address
5300 SW 91St Terrace
Ste a
Gainesville, FL 32608-4399
Phone
(352) 337-0551
Fax
(352) 374-2166
NPI assigned
Jul 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY7228 FL Primary

Addresses

Primary practice location

5300 SW 91St Terrace
Ste a
Gainesville, FL 32608-4399

Mailing address

5300 SW 91St Terrace
Ste a
Gainesville, FL 32608-4399
Phone (352) 337-0551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20070302000114 FL Practitioner - Clinical Psychologist 1850493255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

163 5TH Avenue NE
St. Petersburg, FL 33701-3015
Phone (727) 748-4525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY7228FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Teresa M Picciocchi PSYD Inc Clinical CurrentSince Sep 2, 2008 Accepting new patients

Locations

2655 Ulmerton Rd
Clearwater, FL 33762
Phone (443) 625-5439

4965 SW 91st Ter
Ste A
Gainesville, FL 32608
Phone (352) 337-0551

163 5th Ave NE
St Petersburg, FL 33701
Phone (727) 586-5192

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508887696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 SW 91ST TERRACE",
            "address_2": "STE A",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326084399",
            "telephone_number": "352-337-0551",
            "fax_number": "352-374-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 SW 91ST TERRACE",
            "address_2": "STE A",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326084399",
            "telephone_number": "352-337-0551",
            "fax_number": "352-374-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICCIOCCHI",
        "first_name": "TERESA",
        "middle_name": "M",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.