NPIMap

Organization Active NPI

Paul Modesto, PH.D.,P.a.

  • Clinical Psychologist
  • Boca Raton, FL
National Provider Identifier
1780683409
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY2368 Issued in FL
Legal business name
PAUL MODESTO, PH.D.,P.A.
Practice address
5301 N Federal Hwy
Boca Raton, FL 33487-4917
Phone
(561) 421-6628
Fax
(561) 241-8651
NPI assigned
Jul 15, 2005
Last updated
Oct 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Authorized official

Name
Dr. Paul Modesto, PH.D.NPI 1629113568
Title
Psychologist
Phone
(561) 241-6628

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY2368 FL Primary

Addresses

Primary practice location

5301 N Federal Hwy
Boca Raton, FL 33487-4917

Mailing address

5301 N Federal Hwy
Boca Raton, FL 33487-4910
Phone (561) 421-6628

Other names 1

  • Paul Kulcsar,Ph.D. Former legal business name

National Provider Directory

National Provider Directory

Locations

5301 N Federal Hwy
Boca Raton, FL 33487
Phone (561) 241-6628

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317859200000",
    "number": "1780683409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 N FEDERAL HWY",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334874910",
            "telephone_number": "561-421-6628",
            "fax_number": "561-241-8651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 N FEDERAL HWY",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334874917",
            "telephone_number": "561-421-6628",
            "fax_number": "561-241-8651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL MODESTO, PH.D.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-15",
        "last_updated": "2011-10-06",
        "status": "A",
        "authorized_official_last_name": "MODESTO",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "561-241-6628",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY2368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paul Kulcsar,Ph.D.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.