Individual provider Active NPI

Barry Jay Shrem, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1245365279
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
014925-1 Issued in NY
Practice address
125 Riverside Dr
Suite 1C
New York, NY 10024-3710
Phone
(212) 362-1509
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
Yes

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
Clinical Psychologist 103TC0700X 014925-1 NY Primary

Addresses

Primary practice location

125 Riverside Dr
Suite 1C
New York, NY 10024-3710

Mailing address

125 Riverside Dr
Suite 1C
New York, NY 10024-3710
Phone (212) 362-1509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 25, 2024 through Jun 25, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
014925-1NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Valley Psychological & Developmental Services, P.C. Clinical CurrentSince Dec 1, 2018 Accepting new patients

Locations

1124 State Route 94
Ste 201
New Windsor, NY 12553
Phone (845) 787-1350

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245365279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 RIVERSIDE DR",
            "address_2": "SUITE 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100243710",
            "telephone_number": "212-362-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 RIVERSIDE DR",
            "address_2": "SUITE 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100243710",
            "telephone_number": "212-362-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHREM",
        "first_name": "BARRY",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "014925-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.