Active NPI
Thomas Benjamin Hildebrandt, PSYD
- Clinical Psychologist
- New York, NY
National Provider Identifier
1437357977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 016951
- Practice address
- 1 Gustave L Levy PL
Box 1230
New York, NY 10029-6500 - Phone
- (212) 659-8673
- NPI assigned
- Jul 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 016951 | NY | Primary |
Addresses
Primary practice location
1 Gustave L Levy PL
Box 1230
New York, NY 10029-6500
Mailing address
1 Gustave L Levy PL
Box 1230
New York, NY 10029-6500
Phone (212) 659-8673
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 19, 2021 through Feb 19, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016951 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437357977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 GUSTAVE L LEVY PL",
"address_2": "BOX 1230",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100296500",
"telephone_number": "212-659-8673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 GUSTAVE L LEVY PL",
"address_2": "BOX 1230",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100296500",
"telephone_number": "212-659-8673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HILDEBRANDT",
"first_name": "THOMAS",
"middle_name": "BENJAMIN",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "016951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.