Michael John Nuccitelli, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

013009 Issued in NY

Practice address

2505 Carmel Ave Ste 210
Brewster, NY 10509-1122

Phone

(845) 629-0205

Fax

(845) 279-6221

NPI assigned

Apr 10, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MN Psychological Services PLLCGroup PAC ID 5294070165, 2 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• MN Psychological Services PLLC

  • Psychologist
  • Brooklyn, NY
  • NPI 1003381708
  Medicare reassignment Care Compare group NPD Authorized official
• Shobin Oommen Physician, PC

  • Behavior Analyst
  • New Hyde Park, NY
  • NPI 1275853129
  Medicare reassignment NPD
• MN Psychological Services PLLC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1124825237
  NPD Authorized official

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740303940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 INNSBRUCK BLVD",
            "city": "HOPEWELL JUNCTION",
            "state": "NY",
            "postal_code": "125338315",
            "telephone_number": "845-629-0205",
            "fax_number": "845-279-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 CARMEL AVE STE 210",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105091122",
            "telephone_number": "845-629-0205",
            "fax_number": "845-279-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUCCITELLI",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "013009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern Medical Group, PLLC
• Craig Andrew Northrop, LCSW
• Lisa Marie Notaristefano, CCC-SLP
• Luigia Gina Notaristefano, M.D.
• Lisa Notaro-Pane, R.D.
• Nymedputnam, Inc. (d.b.a.Putnam Ridge/Putnam Commons RHCF)
• Theresa Margaret O'Halloran, LMHC
• Katherine O'Sullivan, LCSW
• Oak Tree Dental Care PC
• Oak Tree Family Dental

• Clinical Psychologist in Brewster, NY
• Providers in Brewster, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.