Simone F M Collymore, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

013677 Issued in NY

Practice address

212 Fair Street
Suite 2
Kingston, NY 12401

Phone

(845) 338-4784

Fax

(845) 454-1441

NPI assigned

Oct 4, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Gerald Tramontano Senior Care Residential and Community Program

  • Mental Illness Community Based Residential Treatment Facility
  • Mount Arlington, NJ
  • NPI 1396894416

  Clinical Neuropsychologist

  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254960000000",
    "number": "1740375948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 FAIR ST",
            "address_2": "PO BOX 3065",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124023065",
            "telephone_number": "845-338-4784",
            "fax_number": "845-454-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 FAIR STREET",
            "address_2": "SUITE 2",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "12401",
            "telephone_number": "845-338-4784",
            "fax_number": "845-454-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLYMORE",
        "first_name": "SIMONE",
        "middle_name": "F M",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2009-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "013677",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "013677",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Corinne Colbert, MD
• Kristi Colburn, SLP-CCC
• Orion Colfer, MD
• Ian Collins, PHARM.D, RPH
• Kathleen Gail Collins, LCSW-R ,CASAC
• Colon and Rectal Care, P.C.
• Alexis Niocle Colon
• Columbia Memorial Hospital
• Maria Luisa Columbo, CCRN
• Concierge Mental Health Counseling Services PLLC

• Clinical Neuropsychologist in Kingston, NY
• Providers in Kingston, NY by specialty
• Clinical Neuropsychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; 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.