Active NPI
Gerald Leibowitz, PH.D.
- Clinical Psychologist
- Fresh Meadows, NY
National Provider Identifier
1063482370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 003707-1
- Practice address
- 5835 Utopia Pkwy
1B
Fresh Meadows, NY 11365-1526 - Phone
- (347) 395-9757
- Fax
- (718) 465-4503
- NPI assigned
- Jan 26, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 003707-1 | NY | Primary |
Addresses
Primary practice location
5835 Utopia Pkwy
1B
Fresh Meadows, NY 11365-1526
Mailing address
5835 Utopia Pkwy
1B
Fresh Meadows, NY 11365-1526
Phone (347) 395-9757
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7329861 | Other | NY | GHI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040430001049 | NY | Practitioner - Clinical Psychologist | 3274521166 | Practice locations: Fresh Meadows, NY; Great Neck, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- University of Rochester School of Medicine and Dentistry, 1970
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
5835 Utopia Pkwy
Fresh Meadows, NY 11365-1526
Phone (718) 357-3385
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003707-1 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288569600000",
"number": "1063482370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5835 UTOPIA PKWY",
"address_2": "1B",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113651526",
"telephone_number": "347-395-9757",
"fax_number": "718-465-4503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5835 UTOPIA PKWY",
"address_2": "1B",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113651526",
"telephone_number": "347-395-9757",
"fax_number": "718-465-4503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEIBOWITZ",
"first_name": "GERALD",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-26",
"last_updated": "2010-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "003707-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "7329861",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fresh Meadows, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.