Individual provider Active NPI

Diana Mejias-Bergmeier, PSY.D.

  • Clinical Psychologist
  • Brewster, NY
National Provider Identifier
1407133341
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
018183 Issued in NY
Practice address
1620 Route 22
Brewster, NY 10509-4051
Phone
(845) 278-2500
NPI assigned
Nov 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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 018183 NY Primary

Addresses

Primary practice location

1620 Route 22
Brewster, NY 10509-4051

Mailing address

22 Deer Run CT
Carmel, NY 10512-3629
Phone (203) 794-4193

Other practice location 1

22 Deer Run Ct
Carmel, NY 10512-3629
Phone (203) 794-4193

Other identifiers 1

IdentifierTypeStateIssuer
2466626098MedicaidNY

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
I20111117000190 NY Practitioner - Clinical Psychologist 2466626098 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
018183NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nys Office of Mental Health CurrentSince Apr 30, 2024 Accepting new patients
Nys Office of Mental Health Current Accepting new patients
Nys Office of Mental Health CurrentSince Apr 30, 2024 Accepting new patients

Locations

140 Old Orangeburg Rd
Orangeburg, NY 10962
Phone (845) 680-7800

Interoperability endpoints

  • Direct secure messaging: cpa.dianamejias-bergmeier@142175.advancedmd-direct.com

Organizations & group practices 3

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": "1320624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1407133341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 DEER RUN CT",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "105123629",
            "telephone_number": "203-794-4193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 ROUTE 22",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105094051",
            "telephone_number": "845-278-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Deer Run Ct",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "NY",
            "postal_code": "105123629",
            "country_code": "US",
            "telephone_number": "203-794-4193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEJIAS-BERGMEIER",
        "first_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-07",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "018183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2466626098",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, NY

Sources for this page

Verify at the official NPI Registry.