Individual provider Active NPI

Benjamin Adam Feld, PH.D.

  • Clinical Psychologist
  • Merrick, NY
National Provider Identifier
1184007452
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
021692 Issued in NY
Practice address
2072 Lawry LN
Merrick, NY 11566-5316
Phone
(917) 301-0690
NPI assigned
Jul 6, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 021692 NY Primary

Addresses

Primary practice location

2072 Lawry LN
Merrick, NY 11566-5316

Mailing address

2072 Lawry LN
Merrick, NY 11566-5316
Phone (917) 301-0690

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
I20160225001141 NY Practitioner - Clinical Psychologist 0941505192 Practice locations: Merrick, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2072 Lawry LN
Merrick, NY 11566-5316
Phone (917) 301-0690

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021692NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1184007452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2072 LAWRY LN",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115665316",
            "telephone_number": "917-301-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2072 LAWRY LN",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115665316",
            "telephone_number": "917-301-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELD",
        "first_name": "BENJAMIN",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-06",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrick, NY

Sources for this page

Verify at the official NPI Registry.