Anna Marie Vinicombe, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

12623 Issued in NY

Practice address

22 Lawrence Ave Ste 304
Smithtown, NY 11787-3619

Phone

(631) 366-3686

Fax

(631) 224-4992

NPI assigned

Jul 10, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292976000000",
    "number": "1548468713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 LAWRENCE AVE STE 304",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873619",
            "telephone_number": "631-366-3686",
            "fax_number": "631-224-4992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 LAWRENCE AVE STE 304",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873619",
            "telephone_number": "631-366-3686",
            "fax_number": "631-224-4992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINICOMBE",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2010-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "12623",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "12623",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin G Vesey, M.D.
• Olive Marie Villa, LPN
• Village Integrative Family Medicine PLLC
• Village Medical, P.C. (Branch Orthopaedics)
• Vincent M. Mazurek, DDS, PC
• David Viola
• Virginia Beaton FNP- Family Health PC
• Melissa Visconti, LMHC
• Sagit Vishnia, PSYD
• Joseph Robert Vitolo, MD

• Psychologist in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; 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.