Jonathan Joseph Pedro, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

002391 Issued in CT

Practice address

325 Highland Ave
Suite 202
Cheshire, CT 06410-2548

Phone

(203) 271-1430

Fax

(203) 271-1800

NPI assigned

Mar 7, 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

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Connecticut Behavioral Health, LLC

  • Professional Counselor
  • Cheshire, CT
  • NPI 1235171828
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841320876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 HIGHLAND AVE",
            "address_2": "SUITE 202",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064102548",
            "telephone_number": "203-271-1430",
            "fax_number": "203-271-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 HIGHLAND AVE",
            "address_2": "SUITE 202",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064102548",
            "telephone_number": "203-271-1430",
            "fax_number": "203-271-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRO",
        "first_name": "JONATHAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John L. Payne, PT
• Jodi Lynn Peck, LCSW
• Kirsten Magda Pedersen, PA-C
• Pediatric and Adolescent Medicine of Cheshire, LLC
• Pediatric Associates of Cheshire PC
• Beatrice Khatti Peku, DNP, APRN
• Arnold Pellegrini
• Heather Lee Peracchio, M.S., R.D., CD-N
• Caitlyn Perillo, OT
• Brittney Perry, COTA/L

• Clinical Psychologist in Cheshire, CT
• Providers in Cheshire, CT by specialty
• Clinical Psychologist in Connecticut

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.