Organization Active NPI

Integrative Medicine Psychiatry P.C.

  • Psychiatry Physician
  • Brooklyn, NY
National Provider Identifier
1063010718
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
INTEGRATIVE MEDICINE PSYCHIATRY P.C.
Practice address
200 Prospect Park W Ste 1R
Brooklyn, NY 11215-5717
Phone
(212) 621-7770
NPI assigned
Oct 14, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Authorized official

Name
Dr. Beata Lewis, MDNPI 1881853653
Title
President
Phone
(617) 794-8391

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X

Addresses

Primary practice location

200 Prospect Park W Ste 1R
Brooklyn, NY 11215-5717

Mailing address

200 Prospect Park W Ste 1R
Brooklyn, NY 11215-5717
Phone (212) 621-7770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220607000433 NY Part B Supplier - Clinic/Group Practice 1153709993 Receives reassigned benefits from 6 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

200 Prospect Park W
Ste 1R
Brooklyn, NY 11215
Phone (212) 621-7770

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1063010718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PROSPECT PARK W STE 1R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112155717",
            "telephone_number": "212-621-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PROSPECT PARK W STE 1R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112155717",
            "telephone_number": "212-621-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE MEDICINE PSYCHIATRY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-14",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "BEATA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-794-8391",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.