Individual provider Active NPI

Jessie Poveromo, PSYD

  • Cognitive & Behavioral Psychologist
  • Rockville Centre, NY
National Provider Identifier
1619294188
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
018490 Issued in NY
Practice address
165 N Village Ave Ste 216
Rockville Centre, NY 11570-3701
Phone
(516) 665-9669
NPI assigned
Apr 23, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 018490 NY Primary
Clinical Psychologist 103TC0700X 018490 NY

Addresses

Primary practice location

165 N Village Ave Ste 216
Rockville Centre, NY 11570-3701

Mailing address

PO Box 1029
West Babylon, NY 11704-0029
Phone (516) 665-9669

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131118000397 NY Practitioner - Clinical Psychologist 1355577537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bandl Cognitive Behavioral Psychology PLLCGroup PAC ID 1153470828, 7 clinicians

Practice addresses (Care Compare)

165 N Village Ave
Rockville Centre, NY 11570-3701
Phone (516) 665-9669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
B&L Cognitive Behavioral Psychology PLLC Clinical CurrentSince Sep 17, 2013 Accepting new patients

Locations

165 N Village Ave
Ste 216
Rockville Ctr, NY 11570
Phone (516) 665-9669

400 Montauk Hwy
Ste 112
West Islip, NY 11795
Phone (631) 321-7107

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1619294188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1029",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117040029",
            "telephone_number": "516-665-9669",
            "fax_number": "516-665-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 N VILLAGE AVE STE 216",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703701",
            "telephone_number": "516-665-9669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POVEROMO",
        "first_name": "JESSIE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NY",
            "license": "018490",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "018490",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.