Individual provider Active NPI

Jonathan Procter, PHD

  • Professional Counselor
  • Rockville Centre, NY
National Provider Identifier
1891163804
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
007837 Issued in NY
Practice address
100 N Village Ave Ste 18
Rockville Centre, NY 11570-3712
Phone
(917) 520-9366
NPI assigned
Sep 8, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 74384 TX
Counseling Psychologist 103TC1900X 007837 NY
Clinical Child & Adolescent Psychologist 103TC2200X 007837 NY
Professional Counselor 101YP2500X 007837 NY Primary

Addresses

Primary practice location

100 N Village Ave Ste 18
Rockville Centre, NY 11570-3712

Mailing address

100 N Village Ave Ste 18
Rockville Centre, NY 11570-3712
Phone (917) 520-9366

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
I20241009002046 NY Practitioner - Mental Health Counselor 5193256543 Practice locations: Rockville Centre, NY

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Ohio University, College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

55 Front St
Suite 10
Rockville Centre, NY 11570-4040
Phone (631) 877-9301

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74384TXMDProfessional Counselor
007837NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sheila H. Chiffriller, PHD, Psychologist, PLLC Counseling PastSince Jan 21, 2025 Accepting new patients

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1891163804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N VILLAGE AVE STE 18",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703712",
            "telephone_number": "917-520-9366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N VILLAGE AVE STE 18",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703712",
            "telephone_number": "917-520-9366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTER",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-08",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "74384",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NY",
            "license": "007837",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "007837",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NY",
            "license": "007837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.