Individual provider Active NPI

Claudio I. Dicovskiy, MD

  • Psychiatry Physician
  • Paterson, NJ
National Provider Identifier
1932282845
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MA061318 Issued in NJ
Practice address
681 Broadway
Paterson, NJ 07514
Phone
(973) 278-1000
Fax
(973) 278-1709
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MA061318 NJ Primary

Addresses

Primary practice location

681 Broadway
Paterson, NJ 07514

Mailing address

681 Broadway
Paterson, NJ 07514
Phone (973) 278-1000

Other identifiers 1

IdentifierTypeStateIssuer
25MA06131800OtherNJMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110616000525 NJ Practitioner - Psychiatry 9335327535 Practice locations: Paterson, NJ

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

681 Broadway
Paterson, NJ 07514-1421
Phone (973) 278-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA061318NJMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1932282845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "681 BROADWAY",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "07514",
            "telephone_number": "973-278-1000",
            "fax_number": "973-278-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 BROADWAY",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "07514",
            "telephone_number": "973-278-1000",
            "fax_number": "973-278-1709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICOVSKIY",
        "first_name": "CLAUDIO",
        "middle_name": "I.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "MA061318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "25MA06131800",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

Verify at the official NPI Registry.