Individual provider Active NPI

Nestor Ivan Borrero-Bracero, PH.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1003163510
Registry record updated Aug 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
160 W 86TH St
New York, NY 10024-4018
Phone
(212) 362-8755
NPI assigned
Aug 14, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

160 W 86TH St
New York, NY 10024-4018

Mailing address

280 14TH St Apt 4E
Brooklyn, NY 11215-4942
Phone (646) 894-0007

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
020421NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Associates of Boro Park, LLP Past Accepting new patients
MMC OB-GYN Faculty Practice Plan Past Accepting new patients

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": "1344902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344902400000",
    "number": "1003163510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 14TH ST APT 4E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112154942",
            "telephone_number": "646-894-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 W 86TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100244018",
            "telephone_number": "212-362-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORRERO-BRACERO",
        "first_name": "NESTOR",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-14",
        "last_updated": "2012-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.