Organization Active NPI

Daniel Boyle PH.D., Inc.

  • Clinical Psychologist
  • Commack, NY
National Provider Identifier
1649851189
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
DANIEL BOYLE PH.D., INC.
Practice address
5036 Jericho Tpke Ste 203
Commack, NY 11725-2812
Phone
(631) 462-5222
Fax
(631) 462-5258
NPI assigned
Apr 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Authorized official

Name
Daniel Boyle, PH.D.NPI 1184706715
Title
Psychologist
Phone
(631) 462-5222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

5036 Jericho Tpke Ste 203
Commack, NY 11725-2812

Mailing address

5036 Jericho Tpke Ste 203
Commack, NY 11725-2812
Phone (631) 462-5222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220517001211 NY Part B Supplier - Clinic/Group Practice 2860879640 Receives reassigned benefits from 1 practitioner
Practice locations: Commack, NY

National Provider Directory

National Provider Directory

Locations

356 Veterans Memorial Hwy
Ste 5
Commack, NY 11725
Phone (347) 743-9951

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669680000000",
    "number": "1649851189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5036 JERICHO TPKE STE 203",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252812",
            "telephone_number": "631-462-5222",
            "fax_number": "631-462-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5036 JERICHO TPKE STE 203",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252812",
            "telephone_number": "631-462-5222",
            "fax_number": "631-462-5258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL BOYLE PH.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-16",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A",
        "authorized_official_last_name": "BOYLE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "631-462-5222",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.