Charles Philip Colosimo, PH D
Individual provider Active NPI Clinical Psychologist · Las Vegas, NV
NPI 1699831875 · NPPES record last updated Sep 30, 2020
Key facts
- NPI
- 1699831875
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PY0236 (NV)
- Practice address
- 501 S Rancho Dr Ste C14
Las Vegas, NV 89106-4831 - Phone
- (702) 384-7433
- Fax
- (702) 366-1204
- NPI assigned
- Dec 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
501 S Rancho Dr
Suite C14
Las Vegas, NV 89106-4831
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050419000635 | NV | Practitioner - Clinical Psychologist | 4183662372 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| C Philip Colosimo PH D & Associates LTD | Clinical | Current |
Accepting new patients |
Locations
501 S Rancho Dr
Ste C14
Las Vegas, NV 89106
Phone (702) 384-7433
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY0236 | NV | Yes |
Addresses
Primary practice location
501 S Rancho Dr Ste C14
Las Vegas, NV 89106-4831
Mailing address
501 S Rancho Dr Ste C14
Las Vegas, NV 89106-4831
Phone (702) 384-7433
Other providers in Las Vegas, NV
- Marcel Colon
- Yomaira Colon
- Colonial Home Care
- Color Meets Counseling
- Colorful Mind Center for Behavioral Health
- Frankie Colosimo
- Elva Soraya Colosio
- Luz Colosio
- Nina Colquitt
- Randal H. Colquitt
All providers in Las Vegas, NV · Clinical Psychologist in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.