Individual provider Active NPI

Stephen P. Daurio, PH.D.

  • Clinical Psychologist
  • Westfield, NJ
National Provider Identifier
1942409404
Registry record updated Jul 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
009135-1 Issued in NY
Practice address
222 Midwood PL
Westfield, NJ 07090-2510
Phone
(718) 983-5376
NPI assigned
Jul 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2007

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 009135-1 NY Primary

Addresses

Primary practice location

222 Midwood PL
Westfield, NJ 07090-2510

Mailing address

222 Midwood PL
Westfield, NJ 07090-2510
Phone (718) 983-5376

Other identifiers 1

IdentifierTypeStateIssuer
01517711MedicaidNY

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
I20101005000553 NY Practitioner - Clinical Psychologist 1557553831 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009135-1NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespire, Inc. CurrentSince Jan 1, 2015 Accepting new patients
Superior Clinical Care PLLC CurrentSince Oct 3, 2018 Accepting new patients
Lifespire, Inc. CurrentSince Jan 1, 2015 Accepting new patients

Locations

21301 Northern Blvd
Fl 2
Bayside, NY 11361
Phone (718) 721-5444

16210 Jamaica Ave
Ste 7
Jamaica, NY 11432
Phone (718) 454-2700

159 E 125th St
Fl 2
New York, NY 10035
Phone (212) 360-5600

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1184457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184457600000",
    "number": "1942409404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 MIDWOOD PL",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070902510",
            "telephone_number": "718-983-5376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 MIDWOOD PL",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070902510",
            "telephone_number": "718-983-5376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAURIO",
        "first_name": "STEPHEN",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-15",
        "last_updated": "2007-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "009135-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01517711",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westfield, NJ

Sources for this page

Verify at the official NPI Registry.