Individual provider Active NPI

Eleanor Palma, PH.D.

  • Psychologist
  • Bayport, NY
National Provider Identifier
1922357771
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
010403-1 Issued in NY
Practice address
859 Montauk Hwy
Suite 2
Bayport, NY 11705-1634
Phone
(631) 563-8834
Fax
(631) 563-8834
NPI assigned
Sep 6, 2012
Last updated
Mar 14, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 010403-1 NY Primary

Addresses

Primary practice location

859 Montauk Hwy
Suite 2
Bayport, NY 11705-1634

Mailing address

859 Montauk Hwy
Suite 2
Bayport, NY 11705-1634
Phone (631) 563-8834

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
I20130516000676 NY Practitioner - Clinical Psychologist 2062659733 Practice locations: Bayport, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

859 Montauk Hwy
Suite 2
Bayport, NY 11705-1634
Phone (631) 563-8834

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010403-1NYMDPsychologist
010403NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Diane Marascia LCSW PC PastSince Dec 24, 2022 Accepting new patients

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

NPI Registry JSON

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1922357771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 MONTAUK HWY",
            "address_2": "SUITE 2",
            "city": "BAYPORT",
            "state": "NY",
            "postal_code": "117051634",
            "telephone_number": "631-563-8834",
            "fax_number": "631-563-8834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 MONTAUK HWY",
            "address_2": "SUITE 2",
            "city": "BAYPORT",
            "state": "NY",
            "postal_code": "117051634",
            "telephone_number": "631-563-8834",
            "fax_number": "631-563-8834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMA",
        "first_name": "ELEANOR",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-06",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "010403-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayport, NY

Sources for this page

Verify at the official NPI Registry.