Individual provider Active NPI

David Pace, PSY.D.

  • Psychologist
  • Oakdale, NY
National Provider Identifier
1649413535
Registry record updated Oct 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
68 018160 Issued in NY
Practice address
1563 Montauk Hwy
Oakdale, NY 11769-1322
Phone
(631) 563-3162
Fax
(631) 563-3185
NPI assigned
Apr 8, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 68 018160 NY Primary

Addresses

Primary practice location

1563 Montauk Hwy
Oakdale, NY 11769-1322

Mailing address

1563 Montauk Hwy
Oakdale, NY 11769-1322
Phone (631) 563-3162

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
I20090828000625 NY Practitioner - Clinical Psychologist 4981759834 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

Practice addresses (Care Compare)

1563 Montauk Hwy
Oakdale, NY 11769-1322
Phone (631) 563-3162

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
68 018160NYMDPsychologist
018160NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nassau-Suffolk Psychology PC CurrentSince Jun 1, 2011 Accepting new patients

Locations

1563 Montauk Hwy
Oakdale, NY 11769
Phone (631) 563-3162

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": "1239148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254355200000",
    "number": "1649413535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1563 MONTAUK HWY",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691322",
            "telephone_number": "631-563-3162",
            "fax_number": "631-563-3185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1563 MONTAUK HWY",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691322",
            "telephone_number": "631-563-3162",
            "fax_number": "631-563-3185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACE",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-08",
        "last_updated": "2009-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "68 018160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakdale, NY

Sources for this page

Verify at the official NPI Registry.