Active NPI
Monica Deschryver, PH.D.
- Clinical Psychologist
- St James, NY
National Provider Identifier
1831163609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 012864
- Practice address
- 590A N Country Rd
St James, NY 11780-1403 - Phone
- (631) 724-4501
- Fax
- (631) 754-1642
- NPI assigned
- Feb 16, 2006
- Sex
- Female
- 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 | 012864 | NY | Primary |
Addresses
Primary practice location
590A N Country Rd
St James, NY 11780-1403
Mailing address
590A N Country Rd
St James, NY 11780-1403
Phone (631) 724-4501
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01758896 | Medicaid | NY |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040819000656 | NY | Practitioner - Clinical Psychologist | 4789675851 | Practice locations: Saint James, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
590 A N Country Rd
Saint James, NY 11780-1403
Phone (631) 724-4501
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": "1140048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362528000000",
"number": "1831163609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "590A N COUNTRY RD",
"city": "ST JAMES",
"state": "NY",
"postal_code": "117801403",
"telephone_number": "631-724-4501",
"fax_number": "631-754-1642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590A N COUNTRY RD",
"city": "ST JAMES",
"state": "NY",
"postal_code": "117801403",
"telephone_number": "631-724-4501",
"fax_number": "631-754-1642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESCHRYVER",
"first_name": "MONICA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-16",
"last_updated": "2013-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "012864",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01758896",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in St James, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.