Active NPI
Jessica Joy Puttre, PSY.D.
- Psychologist
- Melville, NY
National Provider Identifier
1588937221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 555 Broadhollow Rd 327
Melville, NY 11747-5018 - Phone
- (631) 629-5489
- NPI assigned
- Feb 10, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
555 Broadhollow Rd 327
Melville, NY 11747-5018
Mailing address
3771 Nesconset Hwy
Suite 214
South Setauket, NY 11720-1163
Phone (631) 751-1420
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160203001233 | NY | Practitioner - Clinical Psychologist | 8527362011 | Practice locations: Melville, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
555 Broadhollow Rd
Suite 328
Melville, NY 11747-5001
Phone (631) 629-5489
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019524 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443398400000",
"number": "1588937221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3771 NESCONSET HWY",
"address_2": "SUITE 214",
"city": "SOUTH SETAUKET",
"state": "NY",
"postal_code": "117201163",
"telephone_number": "631-751-1420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 BROADHOLLOW RD 327",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117475018",
"telephone_number": "631-629-5489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUTTRE",
"first_name": "JESSICA",
"middle_name": "JOY",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-10",
"last_updated": "2015-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2015; 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.