Active NPI
Joel Kestenbaum
- Psychiatry Physician
- Brooklyn, NY
National Provider Identifier
1093880528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 116747
- Practice address
- 1545 Atlantic Ave
Brooklyn, NY 11213-1122 - Phone
- (718) 613-4000
- NPI assigned
- Nov 21, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 116747 | NY | Primary |
Addresses
Primary practice location
1545 Atlantic Ave
Brooklyn, NY 11213-1122
Mailing address
182 Beach 135TH St
Belle Harbor, NY 11694-1304
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01659576 | Medicaid | NY |
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 |
|---|---|---|---|
| 116747 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catholic Charities Neigborhood Services | Past | Accepting new patients | |
| The in-Home Psychotherapy Service of Greater Ny, LCSW, P.C. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinical Social Worker
- Glendale, NY
- NPI 1881910131
-
- Clinical Social Worker
- Wantagh, NY
- NPI 1548266638
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213747200000",
"number": "1093880528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "182 BEACH 135TH ST",
"city": "BELLE HARBOR",
"state": "NY",
"postal_code": "116941304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1545 ATLANTIC AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112131122",
"telephone_number": "718-613-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KESTENBAUM",
"first_name": "JOEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-21",
"last_updated": "2008-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "116747",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01659576",
"state": "NY"
}
],
"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 Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.