NPIMap

Individual provider Active NPI

Jamee Noelle Nicoletti, PH.D.

  • Clinical Neuropsychologist
  • Mesa, AZ
National Provider Identifier
1639489255
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY-004438 Issued in AZ
Practice address
1520 S Dobson Rd Ste 203
Mesa, AZ 85202
Phone
(480) 412-8080
Fax
(480) 412-8081
NPI assigned
Oct 16, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 018797 NY
Clinical Neuropsychologist 103G00000X PSY-004438 AZ Primary

Addresses

Primary practice location

1520 S Dobson Rd Ste 203
Mesa, AZ 85202

Mailing address

1520 S Dobson Rd Ste 203
Mesa, AZ 85202-4726
Phone (480) 412-8080

Other practice location 1

1554 Northern Blvd
3rd Floor
Manhasset, NY 11030-3006
Phone (516) 719-3725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131029001207 AZ Practitioner - Clinical Psychologist 6103066931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
District Medical Group IncGroup PAC ID 7315086691, 454 clinicians

Practice addresses (Care Compare)

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone (602) 344-5011

3141 N 3Rd Ave
Phoenix, AZ 85013-4360
Phone (602) 914-1520

Hospital & facility affiliations

  • Valleywise Health Medical Center Hospital, Phoenix, AZ, CCN 030022

Merit-based Incentive Payment System (MIPS)

Final score
95.59 of 100Reported as group
Quality
81.55
Promoting interoperability
100
Improvement activities
40
Cost
79.5

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY-004438AZMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Dec 1, 2020 Accepting new patients
Jamee Nicoletti, PHD, PLLC Psychologist Current Accepting new patients
District Medical Group, Inc CurrentSince Dec 1, 2020 Accepting new patients
District Medical Group, Inc Current Accepting new patients

Locations

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

Organizations & group practices 4

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1287187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1639489255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 S DOBSON RD STE 203",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024726",
            "telephone_number": "480-412-8080",
            "fax_number": "480-412-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 S DOBSON RD STE 203",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85202",
            "telephone_number": "480-412-8080",
            "fax_number": "480-412-8081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1554 Northern Blvd",
            "address_2": "3rd Floor",
            "address_purpose": "LOCATION",
            "city": "Manhasset",
            "state": "NY",
            "postal_code": "110303006",
            "country_code": "US",
            "telephone_number": "516-719-3725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICOLETTI",
        "first_name": "JAMEE",
        "middle_name": "NOELLE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-16",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "018797",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AZ",
            "license": "PSY-004438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.