Active NPI
Michael Pallonetti Sr., CASAC-T
- Addiction (Substance Use Disorder) Counselor
- Jamaica, NY
National Provider Identifier
1548967771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 39006
- Practice address
- 90-02 161St Street
Jamaica, NY 11432-3631 - Phone
- (718) 520-1503
- Fax
- (718) 520-6460
- NPI assigned
- Feb 8, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 39006 | NY | Primary |
Addresses
Primary practice location
90-02 161St Street
Jamaica, NY 11432-3631
Mailing address
79 Glenridge Rd
Glenville, NY 12302-4523
Phone (917) 690-6059
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39006 | NY | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699315200000",
"number": "1548967771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 GLENRIDGE RD",
"city": "GLENVILLE",
"state": "NY",
"postal_code": "123024523",
"telephone_number": "917-690-6059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90-02 161ST STREET",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114323631",
"telephone_number": "718-520-1503",
"fax_number": "718-520-6460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALLONETTI",
"first_name": "MICHAEL",
"name_suffix": "Sr.",
"credential": "CASAC-T",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-08",
"last_updated": "2023-11-07",
"certification_date": "2023-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "39006",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.