Individual provider Active NPI

Jacqueline Schomber, PSYD

  • Clinical Psychologist
  • Melville, NY
National Provider Identifier
1538533344
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
022098 Issued in NY
Practice address
275 Broadhollow Rd Ste 120
Melville, NY 11747-4863
Phone
(845) 279-5908
NPI assigned
Nov 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 022098 NY
Health Psychologist 103TH0004X 022098 NY
Clinical Psychologist 103TC0700X 022098 NY Primary

Addresses

Primary practice location

275 Broadhollow Rd Ste 120
Melville, NY 11747-4863

Mailing address

275 Broadhollow Rd Ste 120
Melville, NY 11747-4863
Phone (845) 279-5908

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190604000436 NY Practitioner - Clinical Psychologist 7214260462 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carmel Psychological Health PCGroup PAC ID 4385530351, 222 clinicians

Practice addresses (Care Compare)

275 Broadhollow Rd
Suite 120
Melville, NY 11747-4863
Phone (845) 279-5908

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
022098NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Hematology Oncology Associates PC Multi-Specialty CurrentSince Apr 17, 2019 Accepting new patients
Carmel Psychological Health, PC Psychologist CurrentSince Sep 8, 2025 Accepting new patients

Locations

667 Stoneleigh Ave
Ste 202
Carmel, NY 10512
Phone (845) 278-5223

275 Broadhollow Rd
Ste 120
Melville, NY 11747
Phone (631) 323-6872

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

1500 Route 112
Ste 6
Port Jefferson Station, NY 11776

1500 Route 112
Bldg 6
Port Jefferson Station, NY 11776
Phone (631) 686-7890

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

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.

NPI Registry JSON

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1538533344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 BROADHOLLOW RD STE 120",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474863",
            "telephone_number": "845-279-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 BROADHOLLOW RD STE 120",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474863",
            "telephone_number": "845-279-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOMBER",
        "first_name": "JACQUELINE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-17",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NY",
            "license": "022098",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "NY",
            "license": "022098",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "022098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

Verify at the official NPI Registry.