Individual provider Active NPI

Robert S. Meyers, PSYD

  • Psychologist
  • Bayside, NY
National Provider Identifier
1295067304
Registry record updated Jul 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
018595-1 Issued in NY
Practice address
4640 Springfield Blvd
Bayside, NY 11361-3517
Phone
(718) 225-5505
NPI assigned
Feb 1, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X P72029 NY
Psychologist 103T00000X 018595-1 NY Primary

Addresses

Primary practice location

4640 Springfield Blvd
Bayside, NY 11361-3517

Mailing address

4640 Springfield Blvd
Bayside, NY 11361-3517
Phone (718) 225-5505

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
I20141024000336 NY Practitioner - Clinical Psychologist 3476770041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4640 Springfield Blvd
Bayside, NY 11361-3517
Phone (718) 831-8305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P72029NYMDPsychologist
018595-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New York Psychological Wellness, PC CurrentSince May 24, 2014 Accepting new patients

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": "1264982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1295067304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 SPRINGFIELD BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613517",
            "telephone_number": "718-225-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 SPRINGFIELD BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613517",
            "telephone_number": "718-225-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYERS",
        "first_name": "ROBERT",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-01",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "P72029",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "018595-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

Verify at the official NPI Registry.