Active NPI
Jennifer Wertovitch, PSY.D.
- Clinical Psychologist
- Brooklyn, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- P104036
- Practice address
- 3512 Quentin Rd Ste 110
Brooklyn, NY 11234-4245 - Phone
- (631) 542-2649
- NPI assigned
- Jan 23, 2020
- Sex
- Female
- Sole proprietor
- No
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 | P104036 | NY | Primary |
Addresses
Primary practice location
3512 Quentin Rd Ste 110
Brooklyn, NY 11234-4245
Mailing address
9 Brunswick Rd
Ronkonkoma, NY 11779-1607
Phone (631) 805-0323
Other practice location 1
9 Brunswick Rd
Ronkonkoma, NY 11779-1607
Phone (631) 805-0323
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
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
74 Fire Island Ave
Suite 7
Babylon, NY 11702-3531
Phone (631) 542-2649
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P104036 | NY | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Knapp Street Psychiatry, PC | Clinical | Current | Accepting new patients |
| Che Senior Psychological Services, PC | Clinical | Current | Accepting new patients |
| Dr. Jennifer Wertovitch PSYD Psychologist PC | Current | Accepting new patients |
Locations
74 Fire Island Ave
Ste 7
Babylon, NY 11702
Phone (516) 654-4949
1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700
3512 Quentin Rd
Ste 110
Brooklyn, NY 11234
Phone (718) 854-8370
300 Cadman Plz W
Fl 12
Brooklyn Heights, NY 11201
Phone (212) 439-7955
250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212
209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625
135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101
Organizations & group practices 3
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.
-
- Psychologist
- LK Ronkonkoma, NY
- NPI 1013740711
-
- Clinical Psychologist
- Brooklyn, NY
- NPI 1023078219
-
- Clinical Psychologist
- Brooklyn, NY
- NPI 1043248776
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579737600000",
"number": "1538799010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 BRUNSWICK RD",
"city": "RONKONKOMA",
"state": "NY",
"postal_code": "117791607",
"telephone_number": "631-805-0323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3512 QUENTIN RD STE 110",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112344245",
"telephone_number": "631-542-2649"
}
],
"practiceLocations": [
{
"address_1": "9 Brunswick Rd",
"address_purpose": "LOCATION",
"city": "Ronkonkoma",
"state": "NY",
"postal_code": "117791607",
"country_code": "US",
"telephone_number": "631-805-0323",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WERTOVITCH",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-23",
"last_updated": "2020-01-23",
"certification_date": "2020-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "P104036",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.