Jeffrey Scott Ditzell, D.O.

Primary specialty

Addiction Psychiatry PhysicianTaxonomy code 2084P0802X

License

235398 Issued in NY

Practice address

138 W 25TH St
Suite #606
New York, NY 10001-7405

Phone

(917) 612-0483

NPI assigned

Mar 18, 2007

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 18, 2018 through Jan 18, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Dr. Ditzell Psychiatry, PLLC

  • Psychiatry Physician
  • New York, NY
  • NPI 1356984173
  NPD (past) Authorized official

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

{
    "created_epoch": "1174176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821112772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 W 25TH ST",
            "address_2": "SUITE #606",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100017405",
            "telephone_number": "917-612-0483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 W 25TH ST",
            "address_2": "SUITE #606",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100017405",
            "telephone_number": "917-612-0483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITZELL",
        "first_name": "JEFFREY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NY",
            "license": "235398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Marie Ditta, M.A.,CCC-SLP
• Ikra Ditta, CASAC-T/COUNSELOR
• Marissa Dittmer
• Claudia Ditu, PTA
• David J Ditullio, MD, PHD
• David Lincoln Diuguid, M.D.
• Seth R Divack, M.D.
• Anjana S Divakaran, M.D
• Margaret Divan, LMT
• Antonio Franco Divanna

• Addiction Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Addiction Psychiatry Physician 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.