Individual provider Active NPI

Eric B Nesbitt, PH D

  • Clinical Psychologist
  • Rochester, NY
National Provider Identifier
1326026188
Registry record updated Feb 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
07373 1 Issued in NY
Practice address
333 Metro Park Ste M104
Rochester
Rochester, NY 14623-2632
Phone
(585) 272-7853
NPI assigned
Jan 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2008

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 07373 1 NY Primary

Addresses

Primary practice location

333 Metro Park Ste M104
Rochester
Rochester, NY 14623-2632

Mailing address

333 Metro Park Ste M104
Rochester
Rochester, NY 14623-2632
Phone (585) 272-7853

Other identifiers 1

IdentifierTypeStateIssuer
00808282MedicaidNY

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
I20050812000356 NY Practitioner - Clinical Psychologist 5294764981 Practice locations: Rochester, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
07373 1NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203033600000",
    "number": "1326026188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 METRO PARK STE M104",
            "address_2": "ROCHESTER",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146232632",
            "telephone_number": "585-272-7853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 METRO PARK STE M104",
            "address_2": "ROCHESTER",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146232632",
            "telephone_number": "585-272-7853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESBITT",
        "first_name": "ERIC",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PH D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2008-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "07373 1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00808282",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.