JACQUELINE LOBOSCO PH.D.
NPI 1225457765
Clinical Neuropsychologist in Port Jefferson, NY

Q: What is Jacqueline Lobosco's NPI number?

The NPI number for Jacqueline Lobosco is 1225457765. It was assigned to this individual provider in the NPPES registry on April 14, 2014.

Q: What is Jacqueline Lobosco's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Q: Is Jacqueline Lobosco enrolled in Medicare?

No. Jacqueline Lobosco has opted out of Medicare through July 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Active since April 14, 2014Opted out of Medicare · through Jul 1, 2027

200 BELLE TERRE RD, PORT JEFFERSON, NY 11777(631) 474-6300 Get Directions Write a Review

NPPES record last updated: April 14, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Jacqueline Lobosco Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELINE LOBOSCO PH.D. (NPI 1225457765) is an individual clinical neuropsychologist in Port Jefferson, New York, licensed in New York (019373) and active in the NPI registry since April 2014. She has opted out of Medicare through July 1, 2027.

NPPES Registry Identity

NPI1225457765

Entity TypeIndividualFemale

Primary Taxonomy103G00000X

Provider Legal NameJACQUELINE LOBOSCOCredential: PH.D.

Location Address200 BELLE TERRE RDPort Jefferson, NY 11777-1928

Mailing Address200 Belle Terre RdPort Jefferson, NY 11777-1928 · (631) 474-6300

Phone(631) 474-6300

Sole ProprietorYes

Enumeration DateApril 14, 2014

✔ NPI 1225457765 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

License✔ Licensed in NY · 019373

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

Also ListedPsychologistTaxonomy 103T00000X · License 019373 (NY)

200 BELLE TERRE RD, Port Jefferson, NY 11777

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Jacqueline Lobosco Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2025 through July 1, 2027.

Opt-Out Effective DateJuly 1, 2025

Opt-Out In Effect ThroughJuly 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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