Active NPI
Robert Paul De Carli, PSYD
- Clinical Psychologist
- Middletown, CT
National Provider Identifier
1992801880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- CTLIC1570
- Practice address
- 11 South Main St
Middletown, CT 06457-3656 - Phone
- (860) 346-1266
- NPI assigned
- Sep 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | CTLIC1570 | CT | Primary |
Addresses
Primary practice location
11 South Main St
Middletown, CT 06457-3656
Mailing address
11 South Main St
Middletown, CT 06457-3656
Phone (860) 346-1266
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0004257507 | Other | AETNA | |
| 060001570CT02 | Other | ANTHEM BCBS | |
| IP294886 | Other | MAGELLAN | |
| 134524 | Other | VALUE OPTIONS | |
| 153151 | Other | MANAGED HEALTH NETWORK | |
| 73825 | Other | CIGNA BH | |
| OV2128 | Other | HEALTH NET | |
| P568966 | Other | OXFORD HEALTH | |
| 015700 | Other | CTCARE | |
| 279844 | Other | PRIVATE HEALTH CARE SYSTE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001570 | CT | MD | Behavioral Analyst |
| CTLIC1570 | CT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992801880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 SOUTH MAIN ST",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064573656",
"telephone_number": "860-346-1266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 SOUTH MAIN ST",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064573656",
"telephone_number": "860-346-1266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE CARLI",
"first_name": "ROBERT",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "CTLIC1570",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0004257507",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "060001570CT02",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "IP294886",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "134524",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEALTH NETWORK",
"identifier": "153151",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BH",
"identifier": "73825",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "OV2128",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH",
"identifier": "P568966",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CTCARE",
"identifier": "015700",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIVATE HEALTH CARE SYSTE",
"identifier": "279844",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Middletown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.