Nicole De Vita, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35S100452200 Issued in NJ

Practice address

204 Grove Ave
Cedar Grove, NJ 07009-1436

Phone

(973) 571-2840

NPI assigned

Oct 24, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 9

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Clinical Psychologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of EssexGroup PAC ID 7214837061, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• County of Essex

  • Psychiatry Physician
  • Cedar Grove, NJ
  • NPI 1922056118
  Medicare reassignment Care Compare group NPD
• Vicki Barnett Psy D PC

  • Psychoanalyst
  • Englewood, NJ
  • NPI 1447463971
  Medicare reassignment NPD
• County of Essex

  • Ophthalmology Physician
  • Cedar Grove, NJ
  • NPI 1114975166
  NPD
• County of Essex

  • Internal Medicine Physician
  • Cedar Grove, NJ
  • NPI 1437107646
  NPD
• County of Essex

  • Public Health or Welfare Agency
  • Cedar Grove, NJ
  • NPI 1447854443
  NPD
• County of Essex

  • Psychologist
  • Cedar Grove, NJ
  • NPI 1679521892
  NPD

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382572800000",
    "number": "1669800900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 GROVE AVE",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 GROVE AVE",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091436",
            "telephone_number": "973-571-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE VITA",
        "first_name": "NICOLE",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-24",
        "last_updated": "2013-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35S100452200",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• County of Essex
• Meredith Force Cozzarelli, MS, CCC-SLP
• Susan Elizabeth Cronk, N.P.
• Jill D'Ambrosio
• Yolanda I Dagnino, M.D.
• Melanie Decastro
• Ellen Hanft Defilipps, LMFT
• Yahya Mete Dikengil, MD
• Doris M. Dinallo, RN, LCADC, LPC, BCPC
• Jessica Robyn Dittami, OTR

• Clinical Psychologist in Cedar Grove, NJ
• Providers in Cedar Grove, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.