Frederick Verdonik, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

011230 Issued in NY

Practice address

51 Glasgow Ave
Jamestown, NY 14701-6413

Phone

(716) 664-8611

NPI assigned

Oct 31, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 9

Addresses

Other identifiers 1

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, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jamestown Psychiatric PCGroup PAC ID 0244314631, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jamestown Psychiatric PC

  • Child & Adolescent Psychiatry Physician
  • Jamestown, NY
  • NPI 1700062247
  Medicare reassignment Care Compare group
• Chautauqua Co. Chapter of Nysarc Inc Dba the Resource Center

  • Multi-Specialty Clinic/Center
  • Jamestown, NY
  • NPI 1982682639
  NPD (past)
• Chautauqua County Chapter of Nysarc Inc

  • Long Term Care Pharmacy
  • Jamestown, NY
  • NPI 1427095892
  NPD (past)
• Jamestown Psychiatric PC

  • Psychiatry Physician
  • Ridgway, PA
  • NPI 1003505132
  NPD (past)

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1942291968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 GLASGOW AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016413",
            "telephone_number": "716-664-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 GLASGOW AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016413",
            "telephone_number": "716-664-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDONIK",
        "first_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "011230",
            "primary": true
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NY",
            "license": "011230",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "011230",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "011230",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NY",
            "license": "011230",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NY",
            "license": "011230",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "NY",
            "license": "011230",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NY",
            "license": "011230",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NY",
            "license": "011230",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02341940",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob Van Wart, DPT
• Ashley Christine Vanepps, COTA/L
• Susan M Varacallo-Lamper, RN CCM
• Umamaheswara Rao Vejendla Physician PC
• Daniel Russell Venable
• Gust P Verleni, PA
• John Joseph Vico, MD
• Tasha R Visosky, LMSW
• Robert C Vonvolen, RPH
• Khanh Thi Nha Vu, M.D.

• Psychologist in Jamestown, NY
• Providers in Jamestown, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; 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.