Individual provider Active NPI

Anita Diane Giunta, PH.D.

  • Clinical Psychologist
  • Islip, NY
National Provider Identifier
1871711366
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
009151 Issued in NY
Practice address
374 Islip Ave
Suite 205
Islip, NY 11751-1807
Phone
(631) 859-0475
Fax
(631) 289-8840
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 009151 NY Primary

Addresses

Primary practice location

374 Islip Ave
Suite 205
Islip, NY 11751-1807

Mailing address

374 Islip Ave
Suite 205
Islip, NY 11751-1807
Phone (631) 859-0475

Other identifiers 1

IdentifierTypeStateIssuer
01040257MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100907000045 NY Practitioner - Clinical Psychologist 2365566825 Practice locations: Islip, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

374 Islip Ave
Suite 205
Islip, NY 11751-1807
Phone (631) 859-0475

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
009151NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1871711366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 ISLIP AVE",
            "address_2": "SUITE 205",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117511807",
            "telephone_number": "631-859-0475",
            "fax_number": "631-289-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 ISLIP AVE",
            "address_2": "SUITE 205",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117511807",
            "telephone_number": "631-859-0475",
            "fax_number": "631-289-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIUNTA",
        "first_name": "ANITA",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "009151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01040257",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Islip, NY

Sources for this page

Verify at the official NPI Registry.