Individual provider Active NPI

Thomas R Mayer, PSY.D

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1326086687
Registry record updated Jul 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
007809 Issued in NY
Practice address
585 Schenectady Ave
Brooklyn, NY 11203-1809
Phone
(718) 604-5270
Fax
(718) 604-6629
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2012

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 007809 NY Primary

Addresses

Primary practice location

585 Schenectady Ave
Brooklyn, NY 11203-1809

Mailing address

585 Schenectady Ave
Managed Care Dept. - 6TH Floor, Blumberg BLDG.
Brooklyn, NY 11203-1809
Phone (718) 604-5239

Other identifiers 1

IdentifierTypeStateIssuer
02658482MedicaidNY

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
I20060124000594 NY Practitioner - Clinical Psychologist 8022032440 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007809NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Interfaith Professional Physician Services, P.C. CurrentSince Jun 17, 2025 Accepting new patients
Interfaith Emergency Medicine, P.C. Current Accepting new patients

Locations

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

585 Schenectady Ave
Brooklyn, NY 11203
Phone (718) 604-0461

585 Schenectady Ave
Fl 6
Brooklyn, NY 11203

1110 Eastern Pkwy
Pier Toussaint
Brooklyn, NY 11213
Phone (718) 735-1900

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 2

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341532800000",
    "number": "1326086687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 SCHENECTADY AVE",
            "address_2": "MANAGED CARE DEPT. - 6TH FLOOR, BLUMBERG BLDG.",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031809",
            "telephone_number": "718-604-5239",
            "fax_number": "718-604-5468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 SCHENECTADY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031809",
            "telephone_number": "718-604-5270",
            "fax_number": "718-604-6629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYER",
        "first_name": "THOMAS",
        "middle_name": "R",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2012-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "007809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02658482",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.