Individual provider Active NPI

Daisy Lizette Salvia, PSY.D.

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1619118585
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
018031-1 Issued in NY
Practice address
5110 12TH Ave
Brooklyn, NY 11219-3424
Phone
(800) 275-3243
Fax
(718) 854-8370
NPI assigned
Mar 23, 2009
Last updated
Jul 2, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 018031-1 NY Primary

Addresses

Primary practice location

5110 12TH Ave
Brooklyn, NY 11219-3424

Mailing address

3512 Quentin Rd
Brooklyn, NY 11234-4231
Phone (800) 275-3243

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • 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
I20090408000400 NY Practitioner - Clinical Psychologist 8325195308 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
018031-1NYMDClinical Psychologist
018031NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: daisysalvia@tdh.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341187200000",
    "number": "1619118585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3512 QUENTIN RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112344231",
            "telephone_number": "800-275-3243",
            "fax_number": "718-854-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 12TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112193424",
            "telephone_number": "800-275-3243",
            "fax_number": "718-854-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALVIA",
        "first_name": "DAISY",
        "middle_name": "LIZETTE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-23",
        "last_updated": "2012-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "018031-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.