William Somerville, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

022436 Issued in NY

Practice address

1639 Centre St # 141
Ridgewood, NY 11385-5335

Phone

(718) 594-2458

Fax

(718) 425-9862

NPI assigned

Apr 12, 2015

Last updated

Nov 17, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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 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

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alliance Psychological Services of New York, PLLC

  • Clinical Psychologist
  • Ridgewood, NY
  • NPI 1508374646
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1428796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573948800000",
    "number": "1891181368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1639 CENTRE ST # 141",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113855335",
            "telephone_number": "718-971-9731",
            "fax_number": "718-425-9862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1639 CENTRE ST # 141",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113855335",
            "telephone_number": "718-594-2458",
            "fax_number": "718-425-9862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Bedford Ave Rm B-1005",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112252010",
            "country_code": "US",
            "telephone_number": "718-270-4980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOMERVILLE",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-12",
        "last_updated": "2019-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "022436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Ridgewood, NY
• Providers in Ridgewood, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2019; 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.

Verify at the official NPI Registry.