Active NPI
Jeffrey J. Magnavita, PH.D.
- Psychologist
- Glastonbury, CT
National Provider Identifier
1922280569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1008
- Practice address
- 300 Hebron Ave
Suite 215
Glastonbury, CT 06033-2176 - Phone
- (860) 659-1202
- Fax
- (860) 657-1535
- NPI assigned
- Dec 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1008 | CT | Primary |
Addresses
Primary practice location
300 Hebron Ave
Suite 215
Glastonbury, CT 06033-2176
Mailing address
300 Hebron Ave.
Suite 215
Glastonbury, CT 06033-0651
Phone (860) 659-1202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Aug 30, 2023 through Aug 30, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196812800000",
"number": "1922280569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 HEBRON AVE.",
"address_2": "SUITE 215",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060330651",
"telephone_number": "860-659-1202",
"fax_number": "860-657-1535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 HEBRON AVE",
"address_2": "SUITE 215",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060332176",
"telephone_number": "860-659-1202",
"fax_number": "860-657-1535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGNAVITA",
"first_name": "JEFFREY",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-12-05",
"last_updated": "2007-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CT",
"license": "1008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glastonbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.