Marlon R Koenigsberg, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

008415 Issued in NY

Practice address

850 Hopkins Road
Williamsville, NY 14221-1729

Phone

(716) 688-9641

Fax

(716) 688-9645

NPI assigned

May 17, 2006

Last updated

Nov 9, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Psychologist

Education

State University of New York at Buffalo School of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ub Family Medicine IncGroup PAC ID 1658361381, 37 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ub Family Medicine, Inc

  dba UBMD Primary Care

  • Family Medicine Physician
  • Williamsville, NY
  • NPI 1942294467
  Medicare reassignment Care Compare group NPD
• University Emergency Medical Services Inc.

  • Emergency Medicine Physician
  • Buffalo, NY
  • NPI 1972540482
  NPD
• Academic Medicine Services, Inc.

  dba UBMD Internal Medicine

  • Internal Medicine Physician
  • Williamsville, NY
  • NPI 1255394763
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1538112164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 GOODELL STREET",
            "address_2": "STE. 240",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031243",
            "telephone_number": "716-645-9694",
            "fax_number": "716-845-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HOPKINS ROAD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142211729",
            "telephone_number": "716-688-9641",
            "fax_number": "716-688-9645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIGSBERG",
        "first_name": "MARLON",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "008415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00930589",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric J Koch, DO
• Todd Brian Koch, M.D.
• Upasana Kochhar, M.D.
• Sukhwinder Singh Kodial, M.D.
• Halley Koehler, RN
• Alicia Kohlhagen, LCSW-R
• Nivedita Kohli, R.PH
• Rakhi Kohli
• Charles William Kohout, DDS
• Natalie Kokotow, O.D.

• Clinical Psychologist in Williamsville, NY
• Providers in Williamsville, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.