Individual provider Active NPI

Marian Rissenberg, PH.D.

  • Clinical Neuropsychologist
  • Katonah, NY
National Provider Identifier
1457634354
Registry record updated Mar 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
009016 Issued in NY
Practice address
125 Katonah Ave
Katonah, NY 10536-2136
Phone
(914) 232-6245
Fax
(914) 232-6245
NPI assigned
Sep 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 009016 NY Primary
Adult Development & Aging Psychologist 103TA0700X 009016 NY
Clinical Child & Adolescent Psychologist 103TC2200X 009016 NY

Addresses

Primary practice location

125 Katonah Ave
Katonah, NY 10536-2136

Mailing address

125 Katonah Ave
Katonah, NY 10536-2136
Phone (914) 232-6245

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
I20111104000216 NY Practitioner - Clinical Psychologist 5092988121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

125 Katonah Ave
Katonah, NY 10536-2136
Phone (914) 232-6245

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009016NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Marian Rissenberg, PH.D., Neuropsychologist, PLLC Clinical Neuropsychologist CurrentSince Oct 7, 2011 Accepting new patients

Locations

125 Katonah Ave
Katonah, NY 10536
Phone (914) 232-6245

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": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457049600000",
    "number": "1457634354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 KATONAH AVE",
            "city": "KATONAH",
            "state": "NY",
            "postal_code": "105362136",
            "telephone_number": "914-232-6245",
            "fax_number": "914-232-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 KATONAH AVE",
            "city": "KATONAH",
            "state": "NY",
            "postal_code": "105362136",
            "telephone_number": "914-232-6245",
            "fax_number": "914-232-6245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISSENBERG",
        "first_name": "MARIAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2016-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "009016",
            "primary": true
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NY",
            "license": "009016",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "009016",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katonah, NY

Sources for this page

Verify at the official NPI Registry.