Eleanor Barbera, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

10963 Issued in NY

Practice address

3420 79TH St
Apt 3a
Jackson Heights, NY 11372-2601

Phone

(212) 851-8100

Fax

(889) 772-5478

NPI assigned

Jul 26, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 1, 2022 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• East Coast Wound Care, P.C.

  • Specialist
  • Yonkers, NY
  • NPI 1326350166
  NPD (past)
• Waterview Nursing Care Center, Inc.

  • Skilled Nursing Facility
  • Flushing, NY
  • NPI 1811072929
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1023032117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 79TH ST",
            "address_2": "#3A",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113722607",
            "telephone_number": "646-322-2885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 79TH ST",
            "address_2": "APT 3A",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113722601",
            "telephone_number": "212-851-8100",
            "fax_number": "889-772-5478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARBERA",
        "first_name": "ELEANOR",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "10963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI MEDICARE",
            "identifier": "02856",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01653185",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bam Medical, P.C.
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• Baraka Sadc Inc
• Bari Adult Day Care LLC
• Asef Bari
• Raisa Bari, M.ED
• Cesar Bariso, M.D.
• Valcina Barker

• Clinical Psychologist in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.