Individual provider Active NPI

Giuseppe Sottile, PH.D.

  • Clinical Psychologist
  • Staten Island, NY
National Provider Identifier
1972862720
Registry record updated Jul 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
019523 Issued in NY
Practice address
88 Old Town Rd
Staten Island, NY 10304-4212
Phone
(718) 979-5000
Fax
(718) 980-1298
NPI assigned
May 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2012

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 019523 NY Primary

Addresses

Primary practice location

88 Old Town Rd
Staten Island, NY 10304-4212

Mailing address

1928 69TH St
Brooklyn, NY 11204-4544
Phone (347) 386-5691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • 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
I20120523000088 NY Practitioner - Clinical Psychologist 9931139730 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019523NYMDPhysician Assistant

Organizations & group practices 2

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": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341532800000",
    "number": "1972862720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1928 69TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112044544",
            "telephone_number": "347-386-5691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 OLD TOWN RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044212",
            "telephone_number": "718-979-5000",
            "fax_number": "718-980-1298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTTILE",
        "first_name": "GIUSEPPE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-15",
        "last_updated": "2012-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.