Active NPI
Lawrence Bruce Jacobsberg, M.D.
- Psychiatry Physician
- New York, NY
National Provider Identifier
1114909280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 151142
- Practice address
- 220 E 63Rd St
New York, NY 10021-7660 - Phone
- (212) 371-5201
- NPI assigned
- Nov 15, 2005
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 151142 | NY | Primary |
Addresses
Primary practice location
220 E 63Rd St
New York, NY 10021-7660
Mailing address
220 E 63Rd St
New York, NY 10065-7660
Phone (212) 371-5201
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: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100128000461 | NY | Practitioner - Psychiatry | 8628110640 | Practice locations: New York, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Harvard Medical School, 1981
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
220 E 63Rd St
New York, NY 10065-7660
Phone (212) 371-5201
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 151142 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299283200000",
"number": "1114909280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 E 63RD ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100657660",
"telephone_number": "212-371-5201",
"fax_number": "212-371-5159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 E 63RD ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100217660",
"telephone_number": "212-371-5201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSBERG",
"first_name": "LAWRENCE",
"middle_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-15",
"last_updated": "2011-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "151142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2011; 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.