Active NPI
Jonathan Fiskus, PSYD
- Clinical Psychologist
- Brooklyn, NY
National Provider Identifier
1104235738
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 023153
- Practice address
- 1623 Kings Hwy
Brooklyn, NY 11229-1209 - Phone
- (718) 375-1200
- NPI assigned
- Aug 7, 2014
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 023153 | NY | Primary |
Addresses
Primary practice location
1623 Kings Hwy
Brooklyn, NY 11229-1209
Mailing address
1623 Kings Hwy
Brooklyn, NY 11229-1209
Phone (718) 375-1200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 18, 2026 through Mar 18, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563148800000",
"number": "1104235738",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1623 KINGS HWY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112291209",
"telephone_number": "718-375-1200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1623 KINGS HWY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112291209",
"telephone_number": "718-375-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISKUS",
"first_name": "JONATHAN",
"name_prefix": "Mr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-07",
"last_updated": "2019-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "023153",
"primary": true
}
],
"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 Jul 15, 2019; 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.