Active NPI
Ivan Bresgi, PH.D.
- Clinical Psychologist
- New York, NY
National Provider Identifier
1053524900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 9320
- Practice address
- 20 W 86TH St
Suite 1D
New York, NY 10024-3604 - Phone
- (212) 724-4992
- NPI assigned
- May 8, 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 9320 | NY | |
| Clinical Psychologist | 103TC0700X | 9320 | NY | Primary |
| Family Psychologist | 103TF0000X | 9320 | NY | |
| Psychoanalysis Psychologist | 103TP0814X | 9320 | NY | |
| Group Psychotherapy Psychologist | 103TP2701X | 9320 | NY |
Addresses
Primary practice location
20 W 86TH St
Suite 1D
New York, NY 10024-3604
Mailing address
20 W 86TH St
Suite 1D
New York, NY 10024-3604
Phone (212) 724-4992
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 14, 2021 through Jul 14, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9320 | NY | MD | Group Psychotherapy Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205107200000",
"number": "1053524900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 W 86TH ST",
"address_2": "SUITE 1D",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100243604",
"telephone_number": "212-724-4992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 W 86TH ST",
"address_2": "SUITE 1D",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100243604",
"telephone_number": "212-724-4992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRESGI",
"first_name": "IVAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-08",
"last_updated": "2008-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "9320",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "9320",
"primary": true
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "NY",
"license": "9320",
"primary": false
},
{
"code": "103TP0814X",
"taxonomy_group": "",
"desc": "Psychologist, Psychoanalysis",
"state": "NY",
"license": "9320",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "NY",
"license": "9320",
"primary": false
}
],
"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 Mar 10, 2008; 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.