Individual provider Active NPI

Brian Keith Lebowitz, PHD

  • Clinical Neuropsychologist
  • East Setauket, NY
National Provider Identifier
1275791816
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
017235 Issued in NY
Practice address
179 Belle Mead Rd
East Setauket, NY 11733-3456
Phone
(631) 444-8053
Fax
(631) 444-1975
NPI assigned
May 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 017235 NY Primary
Clinical Psychologist 103TC0700X 017235 NY

Addresses

Primary practice location

179 Belle Mead Rd
East Setauket, NY 11733-3456

Mailing address

179 Belle Mead Rd
East Setauket, NY 11733-3456
Phone (631) 444-8053

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
I20080905000271 NY Practitioner - Clinical Psychologist 4789750308

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital at Stony Brook Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: brian.lebowitz@direct.stonybrookmedicine.edu

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": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212105600000",
    "number": "1275791816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 BELLE MEAD RD",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333456",
            "telephone_number": "631-444-8053",
            "fax_number": "631-444-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 BELLE MEAD RD",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333456",
            "telephone_number": "631-444-8053",
            "fax_number": "631-444-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBOWITZ",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-30",
        "last_updated": "2008-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "017235",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "017235",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.