Individual provider Active NPI

Shmuel Yitzchak Bieler, MPHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Teaneck, NJ
National Provider Identifier
1447017157
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
405595 Issued in NY
Practice address
1133 Magnolia Rd
Teaneck, NJ 07666-2745
Phone
(201) 403-4206
NPI assigned
Feb 29, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 405595 NY Primary

Addresses

Primary practice location

1133 Magnolia Rd
Teaneck, NJ 07666-2745

Mailing address

1133 Magnolia Rd
Teaneck, NJ 07666-2745
Phone (201) 403-4206

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240423002546 NY Practitioner - Nurse Practitioner 1557700572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahava Medical and Rehabilitation Center, LLCGroup PAC ID 1557416997, 150 clinicians

Practice addresses (Care Compare)

2555 Nostrand Ave
Brooklyn, NY 11210-4730
Phone 71895188002102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ahava Medical and Rehabilitation Center, LLC CurrentSince Apr 1, 2024 Accepting new patients

Locations

2555 Nostrand Ave
Brooklyn, NY 11210
Phone 7189518800108

25 Carrier St
Liberty, NY 12754
Phone (718) 755-0332

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": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1447017157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 MAGNOLIA RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076662745",
            "telephone_number": "201-403-4206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 MAGNOLIA RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076662745",
            "telephone_number": "201-403-4206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIELER",
        "first_name": "SHMUEL",
        "middle_name": "YITZCHAK",
        "name_prefix": "Mr.",
        "credential": "MPHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.