Individual provider Active NPI

Moses Weksler, PH.D.

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1457417545
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
05186 Issued in NY
Practice address
1455 55TH St
Brooklyn, NY 11219-4257
Phone
(718) 853-3593
Fax
(718) 686-0978
NPI assigned
Dec 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 05186 NY Primary

Addresses

Primary practice location

1455 55TH St
Brooklyn, NY 11219-4257

Mailing address

21614 17TH Ave
Bayside, NY 11360-1222
Phone (718) 428-1037

Other identifiers 8

IdentifierTypeStateIssuer
1060710OtherNYBEACON HEALTH
NY SO 5186-B2OtherNYWORKER'S COMPENSATION
00496075MedicaidNY
P560509OtherNYOXFORD
078711OtherNYVALUE OPTIONS
1015863OtherNYMULTIPLER
0083056OtherNYGHI
5526630OtherNYBLUE CROSS

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
I20041111000630 NY Practitioner - Clinical Psychologist 6709849532 Practice locations: Bayside, NY; Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1455 55TH St
Apt 2E
Brooklyn, NY 11219-4251
Phone (718) 853-3593

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05186NYMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457417545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21614 17TH AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601222",
            "telephone_number": "718-428-1037",
            "fax_number": "718-428-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 55TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112194257",
            "telephone_number": "718-853-3593",
            "fax_number": "718-686-0978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEKSLER",
        "first_name": "MOSES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "05186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH",
            "identifier": "1060710",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKER'S COMPENSATION",
            "identifier": "NY SO 5186-B2",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00496075",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P560509",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "078711",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLER",
            "identifier": "1015863",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0083056",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "5526630",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.