STILLWATER PSYCHOLOGICAL AND OCCUPATIONAL THERAPY ASSOC PLLC
NPI 1982666822
Psychologist - Clinical in Bay Shore, NY

Q: What is Stillwater Psychological And Occupational Therapy Assoc PLLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since April 05, 2006

1840 UNION BLVD, BAY SHORE, NY 11706(631) 647-7885(631) 647-7893 Get Directions Write a Review

NPPES record last updated: June 22, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Stillwater Psychological And Occupational Therapy Assoc Pllc NPPES

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

STILLWATER PSYCHOLOGICAL AND OCCUPATIONAL THERAPY ASSOC PLLC (NPI 1982666822) is a healthcare organization registered as a clinical in Bay Shore, New York and active in the NPI registry since April 2006. The organization lists Shafer Zyzman, Ceo, as its authorized official.

NPPES Registry Identity

NPI1982666822

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameSTILLWATER PSYCHOLOGICAL AND OCCUPATIONAL THERAPY ASSOC PLLC

Location Address1840 UNION BLVDBay Shore, NY 11706-7932

Mailing Address1840 Union BlvdBay Shore, NY 11706-7932 · (631) 647-7885 · Fax (631) 647-7893

Phone(631) 647-7885

Fax(631) 647-7893

Organization SubpartNo

Authorized OfficialShafer ZyzmanCeo · (631) 647-7885

Enumeration DateApril 5, 2006

Last NPPES UpdateJune 22, 2019

✔ NPI 1982666822 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in NY · 011241

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedSocial WorkerTaxonomy 104100000X · License 025669 (NY)

Also ListedOccupational TherapistTaxonomy 225X00000X · License 009040 (NY)

1840 UNION BLVD, Bay Shore, NY 11706

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Other Identifiers 1

Medicaid02678068NY

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stillwater Psychological And Occupational Therapy Assoc Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Stillwater Psychological And Occupational Therapy Assoc PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Patrick Andretta, PH.D.

Clinical Psychologist

NPI 1124253265

6421 BOOTH ST UNIT 4B
Rego Park, NY 11374

(516) 994-1630

✔ PECOS✔ Accepts Medicare32 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stillwater Psychological And Occupational Therapy Assoc PLLC's NPI number?

The NPI number for Stillwater Psychological And Occupational Therapy Assoc PLLC is 1982666822. It was assigned to this organization in the NPPES registry on April 5, 2006.

Where is Stillwater Psychological And Occupational Therapy Assoc PLLC located?

Stillwater Psychological And Occupational Therapy Assoc PLLC is located at 1840 Union Blvd, Bay Shore, NY 11706. The listed phone number is (631) 647-7885.

What is Stillwater Psychological And Occupational Therapy Assoc PLLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Stillwater Psychological And Occupational Therapy Assoc PLLC enrolled in Medicare?

Yes. Stillwater Psychological And Occupational Therapy Assoc PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Stillwater Psychological And Occupational Therapy Assoc PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Stillwater Psychological And Occupational Therapy Assoc PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Stillwater Psychological And Occupational Therapy Assoc PLLC was last updated on June 22, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.