Individual provider Active NPI

Jessica R. Poggioli, PSY.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1922136712
Registry record updated Jul 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
015601 Issued in NY
Practice address
7 W 36TH St
Floor 15
New York, NY 10018-7911
Phone
(212) 874-8180
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2012

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 015601 NY Primary

Addresses

Primary practice location

7 W 36TH St
Floor 15
New York, NY 10018-7911

Mailing address

7 W 36TH St
Floor 15
New York, NY 10018-7911
Phone (212) 874-8180

Other names 1

  • Jessica R. Page Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015601NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342051200000",
    "number": "1922136712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 W 36TH ST",
            "address_2": "FLOOR 15",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100187911",
            "telephone_number": "212-874-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 W 36TH ST",
            "address_2": "FLOOR 15",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100187911",
            "telephone_number": "212-874-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POGGIOLI",
        "first_name": "JESSICA",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2012-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "015601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "PAGE",
            "middle_name": "R.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.