Active NPI
Bella Proskurov, PH.D.
- Clinical Psychologist
- Brooklyn, NY
National Provider Identifier
1497994271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 017568
- Practice address
- 20 Columbia PL
#B44
Brooklyn, NY 11201-4564 - Phone
- (646) 251-3462
- NPI assigned
- Feb 18, 2009
- Last updated
- Feb 18, 2009
- Sex
- Female
- 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 | 017568 | NY | Primary |
Addresses
Primary practice location
20 Columbia PL
#B44
Brooklyn, NY 11201-4564
Mailing address
20 Columbia PL
#B44
Brooklyn, NY 11201-4564
Phone (646) 251-3462
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240517001531 | NY | Order and Referring Only - Clinical Psychologist | 2668507617 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017568 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234915200000",
"number": "1497994271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 COLUMBIA PL",
"address_2": "#B44",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112014564",
"telephone_number": "646-251-3462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 COLUMBIA PL",
"address_2": "#B44",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112014564",
"telephone_number": "646-251-3462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROSKUROV",
"first_name": "BELLA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-18",
"last_updated": "2009-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "017568",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
- Harry Prophete, M.D.
- Stephanie Propper, DR.
- Bryce J Propser, MSW CPHT
- Rosemary M Proscia, R.N.
- Jenna Prosen, MS-SLP
- Alexander Prosky
- Prospect Acquisition I LLC (Downtown Brooklyn Nursing and Rehabilitation Center)
- Prospect Acquisition III LLC (Cassena Care at Home)
- Prospect Ave. Medical P.C. (Prospect Medical)
- Prospect Care Pharmacy
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.