Individual provider Active NPI

Rosanne Pachilakis, PSY. D.

  • Clinical Psychologist
  • Glen Cove, NY
National Provider Identifier
1669576161
Registry record updated Nov 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
016212-1 Issued in NY
Practice address
101 Saint Andrews LN
Glen Cove, NY 11542-2254
Phone
(516) 674-7500
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2023

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 016212-1 NY Primary

Addresses

Primary practice location

101 Saint Andrews LN
Glen Cove, NY 11542-2254

Mailing address

101 Saint Andrews LN
Glen Cove, NY 11542-2254

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
I20061107000183 NY Practitioner - Clinical Psychologist 5799782645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

1554 Northern Blvd
FL 3
Manhasset, NY 11030-3006
Phone (516) 472-5800

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016212-1NYMDClinical Psychologist
016212NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Growth Mindset Psychological Services, P.C. Current Accepting new patients
North Shore-Lij Medical PC CurrentSince Feb 28, 2023 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

101 Saint Andrews Ln
Glen Cove, NY 11542
Phone (516) 674-7300

611 Northern Blvd
Great Neck, NY 11021
Phone (516) 325-7000

560 Northern Blvd
Ste 206
Great Neck, NY 11021
Phone (516) 466-5166

1554 Northern Blvd
Fl 3
Manhasset, NY 11030
Phone (516) 472-5800

1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 2

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699056000000",
    "number": "1669576161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SAINT ANDREWS LN",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SAINT ANDREWS LN",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422254",
            "telephone_number": "516-674-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHILAKIS",
        "first_name": "ROSANNE",
        "credential": "PSY. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2023-11-04",
        "certification_date": "2023-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016212-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

Verify at the official NPI Registry.