Individual provider Active NPI

Brenda H Lavi, PHD

  • Psychologist
  • New York, NY
National Provider Identifier
1114053865
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0102121 Issued in NY
Practice address
1155 Park Ave
New York, NY 10128
Phone
(917) 239-4147
NPI assigned
Feb 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 0102121 NY Primary

Addresses

Primary practice location

1155 Park Ave
New York, NY 10128

Mailing address

31 Merrick Ave
Suite 110
Merrick, NY 11566
Phone (516) 379-7100

Other identifiers 5

IdentifierTypeStateIssuer
P441747OtherNYOXFORD
P83405683OtherNYMULTIPLAN
068423OtherNYVALUE OPTIONS
AB00778OtherNYMDNY
6800205OtherNYGHI

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110201000602 NY Practitioner - Clinical Psychologist 6204015688 Practice locations: New York, NY; Merrick, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

31 Merrick Ave
Suite 110
Merrick, NY 11566-3406
Phone (516) 379-7100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0102121NYMDPsychologist
010212NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114053865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 MERRICK AVE",
            "address_2": "SUITE 110",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "11566",
            "telephone_number": "516-379-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10128",
            "telephone_number": "917-239-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVI",
        "first_name": "BRENDA",
        "middle_name": "H",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "0102121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P441747",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "P83405683",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "068423",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDNY",
            "identifier": "AB00778",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6800205",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.