Individual provider Active NPI

Benjamin Hirsch, PH.D.

  • Adult Development & Aging Psychologist
  • East Meadow, NY
National Provider Identifier
1396869335
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Development & Aging PsychologistTaxonomy code 103TA0700X
Practice address
1369 N Jerusalem Rd
East Meadow, NY 11554-4538
Phone
(516) 485-4080
Fax
(516) 485-4081
NPI assigned
Mar 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 4033 NY
Psychologist 103T00000X
Adult Development & Aging Psychologist 103TA0700X Primary
Cognitive & Behavioral Psychologist 103TB0200X
Clinical Psychologist 103TC0700X 4033 NY
Clinical Child & Adolescent Psychologist 103TC2200X
Family Psychologist 103TF0000X
Forensic Psychologist 103TF0200X
Psychologist 103T00000X 4033 NY
Rehabilitation Psychologist 103TR0400X

Addresses

Primary practice location

1369 N Jerusalem Rd
East Meadow, NY 11554-4538

Mailing address

1369 N Jerusalem Rd
East Meadow, NY 11554-4538
Phone (516) 485-4080

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
I20110516000050 NY Practitioner - Clinical Psychologist 5991991101 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4033NYMDAddiction (Substance Use Disorder) Counselor
004033NYMDMental Health Counselor

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1396869335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1369 N JERUSALEM RD",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115544538",
            "telephone_number": "516-485-4080",
            "fax_number": "516-485-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1369 N JERUSALEM RD",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115544538",
            "telephone_number": "516-485-4080",
            "fax_number": "516-485-4081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRSCH",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "4033",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "4033",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "4033",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

Verify at the official NPI Registry.