Individual provider Active NPI

Bruce S Herman, PHD

  • Psychologist
  • New Hyde Park, NY
National Provider Identifier
1356488282
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5348 Issued in NY
Practice address
2001 Marcus Ave
Suite N214
New Hyde Park, NY 11042-1011
Phone
(516) 358-9000
Fax
(516) 358-9802
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 5348 NY Primary

Addresses

Primary practice location

2001 Marcus Ave
Suite N214
New Hyde Park, NY 11042-1011

Mailing address

2001 Marcus Ave
Suite N214
New Hyde Park, NY 11042-1011
Phone (516) 358-9000

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
I20060425000662 NY Practitioner - Clinical Psychologist 5698785376 Practice locations: New Hyde Park, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2001 Marcus Ave
New Hyde Park, NY 11042-1011
Phone (516) 358-9800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5348NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiatry Associates PC Past 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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1356488282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE",
            "address_2": "SUITE N214",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421011",
            "telephone_number": "516-358-9000",
            "fax_number": "516-358-9802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MARCUS AVE",
            "address_2": "SUITE N214",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421011",
            "telephone_number": "516-358-9000",
            "fax_number": "516-358-9802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMAN",
        "first_name": "BRUCE",
        "middle_name": "S",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "5348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.