Individual provider Active NPI

Barry Reisberg, M.D.

  • Geriatric Psychiatry Physician
  • New York, NY
National Provider Identifier
1023155504
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
MD 117071 Issued in NY
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
117071NYMDSocial Worker
MD 117071NYMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nyumc Aging Center Associates PastSince Dec 6, 2009 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.

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.

Verify at the official NPI Registry.