Individual provider Active NPI

Gerard P Lippert, MD

  • Psychiatry Physician
  • Ithaca, NY
National Provider Identifier
1013955152
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2172491 Issued in NY
Practice address
201 East Green St
Ithaca, NY 14850
Phone
(607) 274-6200
Fax
(607) 274-6316
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X 2172491 NY
Psychiatry Physician 2084P0800X 2172491 NY Primary

Addresses

Primary practice location

201 East Green St
Ithaca, NY 14850

Mailing address

201 East Green St
Ithaca, NY 14850
Phone (607) 274-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110420000041 NY Practitioner - Psychiatry 1557546413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tompkins CountyGroup PAC ID 0143210443, 19 clinicians

Practice addresses (Care Compare)

201 E Green St
Ithaca, NY 14850-5635
Phone (607) 274-6200

Hospital & facility affiliations

  • Cayuga Medical Center at Ithaca Hospital, Ithaca, NY, CCN 330307

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
217249NYMDLicensed Practical Nurse
2172491NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tompkins County CurrentSince May 22, 2000 Accepting new patients

Locations

201 E Green St
Ithaca, NY 14850
Phone (607) 274-6200

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202860800000",
    "number": "1013955152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 EAST GREEN ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "14850",
            "telephone_number": "607-274-6200",
            "fax_number": "607-274-6316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 EAST GREEN ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "14850",
            "telephone_number": "607-274-6200",
            "fax_number": "607-274-6316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPPERT",
        "first_name": "GERARD",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2008-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "NY",
            "license": "2172491",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "2172491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.