Active NPI
Silvio Machado, PSYCHOLOGIST
- Clinical Psychologist
- Petaluma, CA
National Provider Identifier
1730443359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY25053
- Practice address
- 115 Liberty St
Ste 10
Petaluma, CA 94952-2320 - Phone
- (707) 529-3021
- NPI assigned
- Jun 28, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY25053 | CA | Primary |
Addresses
Primary practice location
115 Liberty St
Ste 10
Petaluma, CA 94952-2320
Mailing address
PO Box 325
Petaluma, CA 94953-0325
Phone (707) 529-3021
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598786352 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130102000387 | CA | Practitioner - Clinical Psychologist | 7719130590 | Practice locations: Petaluma, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
7 4TH St
Suite 45
Petaluma, CA 94952-7402
Phone (707) 529-3021
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632787200000",
"number": "1730443359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 325",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949530325",
"telephone_number": "707-529-3021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 LIBERTY ST",
"address_2": "STE 10",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949522320",
"telephone_number": "707-529-3021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACHADO",
"first_name": "SILVIO",
"name_prefix": "Dr.",
"credential": "PSYCHOLOGIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-28",
"last_updated": "2021-09-28",
"certification_date": "2021-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY25053",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1598786352",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Petaluma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.