Individual provider Active NPI

Ilona Bakman

  • Mental Health Counselor
  • Forest Hills, NY
National Provider Identifier
1386371649
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
008896 Issued in NY
Practice address
10470 Queens Blvd Ste 200
Forest Hills, NY 11375-3694
Phone
(917) 478-0884
NPI assigned
Aug 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 008896 NY Primary

Addresses

Primary practice location

10470 Queens Blvd Ste 200
Forest Hills, NY 11375-3694

Mailing address

21 Travis Ave
Staten Island, NY 10314-6209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240213002729 NY Practitioner - Mental Health Counselor 5991148363 Reassigns benefits to 1 organization
I20240716000095 NJ Practitioner - Marriage and Family Therapist 5991148363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Supportive Care Psychology of NJ PCGroup PAC ID 6002162252, 23 clinicians

Practice addresses (Care Compare)

2150 Route 38
Cherry Hill, NJ 08002-4302
Phone (718) 298-4375

560 Berkeley Ave
Orange, NJ 07050-2109
Phone (718) 298-4375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care Psychology of NJ PC CurrentSince Jun 1, 2024 Accepting new patients
Bleuler Psychotherapy Center, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

560 Berkeley Ave
Orange, NJ 07050
Phone (973) 672-6500

10470 Queens Blvd
Ste 200
Forest Hills, NY 11375
Phone (866) 404-6913

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/bleulerpc/r4/

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": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1386371649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 TRAVIS AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10470 QUEENS BLVD STE 200",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753694",
            "telephone_number": "917-478-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKMAN",
        "first_name": "ILONA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-05",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "008896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.