Individual provider Active NPI

Eliezer Robert Mayer, PSY.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1538150602
Registry record updated Sep 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
009386 Issued in NY
Practice address
26 W 9TH St
Suite 4B
New York, NY 10011-8971
Phone
(212) 242-2219
Fax
(212) 242-2219
NPI assigned
Oct 28, 2005
Last updated
Sep 14, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2009

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 009386 NY Primary

Addresses

Primary practice location

26 W 9TH St
Suite 4B
New York, NY 10011-8971

Mailing address

26 W 9TH St
Suite 4B
New York, NY 10011-8971
Phone (212) 242-2219

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
I20040414001439 NY Practitioner - Clinical Psychologist 4082608658 Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1405 8TH Ave
Apt 1C
Brooklyn, NY 11215-8206
Phone (917) 495-6021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009386NYMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252886400000",
    "number": "1538150602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 W 9TH ST",
            "address_2": "SUITE 4B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118971",
            "telephone_number": "212-242-2219",
            "fax_number": "212-242-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 W 9TH ST",
            "address_2": "SUITE 4B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100118971",
            "telephone_number": "212-242-2219",
            "fax_number": "212-242-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYER",
        "first_name": "ELIEZER",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2009-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "009386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.