Active NPI
Barry Reisberg, M.D.
- Geriatric Psychiatry Physician
- New York, NY
National Provider Identifier
1023155504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Psychiatry Physician
- License
- MD 117071
- Practice address
- 20 Waterside Plaza
Suite # 7K
New York, NY 10010-2619 - Phone
- (212) 889-7579
- Fax
- (212) 263-6991
- NPI assigned
- Jan 31, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Psychiatry Physician | 2084P0805X | MD 117071 | NY | Primary |
Addresses
Primary practice location
20 Waterside Plaza
Suite # 7K
New York, NY 10010-2619
Mailing address
20 Waterside Plaza
Suite # 7K
New York, NY 10010-2619
Phone (212) 889-7579
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 117071 | NY | MD | Social Worker |
| MD 117071 | NY | MD | Geriatric Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nyumc Aging Center Associates | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| New York University | Past | Accepting new patients |
Organizations & group practices 3
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.
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- Psychiatry Physician
- New York, NY
- NPI 1205826781
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Cardiovascular Disease Physician
- Boynton Beach, FL
- NPI 1285826438
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023155504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 WATERSIDE PLAZA",
"address_2": "SUITE # 7K",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100102619",
"telephone_number": "212-889-7579",
"fax_number": "212-263-6991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 WATERSIDE PLAZA",
"address_2": "SUITE # 7K",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100102619",
"telephone_number": "212-889-7579",
"fax_number": "212-263-6991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REISBERG",
"first_name": "BARRY",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0805X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Geriatric Psychiatry",
"state": "NY",
"license": "MD 117071",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.