Eugene S. Carroccia, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071-006067 Issued in IL

Practice address

4700 W 95TH St
Suite LL5
Oak Lawn, IL 60453-2533

Phone

(800) 216-1110

Fax

(708) 346-4868

NPI assigned

Apr 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other names 1

• Dr. Gene Carroccia Other name

Medicare fee-for-service enrollment

Enrolled in IL

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, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Edgewood Clinical Services P.C.Group PAC ID 3971963901, 304 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Edgewood Clinical Services, P.C.

  • Psychologist
  • Naperville, IL
  • NPI 1295914646
  Medicare reassignment Care Compare group NPD
• Psychology Specialists LTD

  • Clinical Psychologist
  • Bloomington, IL
  • NPI 1053368605
  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242086400000",
    "number": "1598886103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776",
            "address_2": "ADVOCATE FAMILY CARE NETWORK",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604540776",
            "telephone_number": "800-216-1110",
            "fax_number": "708-346-4868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 W 95TH ST",
            "address_2": "SUITE LL5",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532533",
            "telephone_number": "800-216-1110",
            "fax_number": "708-346-4868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROCCIA",
        "first_name": "EUGENE",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2009-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "IL",
            "license": "071-006067",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-006067",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IL",
            "license": "071-006067",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "IL",
            "license": "071-006067",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "IL",
            "license": "071-006067",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GENE",
            "last_name": "CARROCCIA",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Carmen Gnatenco M.D., S.C.
• Meaghan Reich Carnevale, CRNP
• Carney Speech & Feeding LLC
• Katie Eileen Carney, M.S., CCC-SLP
• Rianda Rae Carodine
• James Carroll, OD
• Payton Elizabeth Carroll, MA
• Anderson Carter
• Christina Carter
• Drake Carter, MD

• Clinical Psychologist in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; 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.