Individual provider Active NPI

Jennifer Wertovitch, PSY.D.

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1538799010
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
P104036 Issued in NY
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

Updated by the provider on Jan 23, 2020

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220405001092 NY Practitioner - Clinical Psychologist 6305232158 Reassigns benefits to 3 organizations

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

LicenseStateTypeSpecialty
P104036NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Knapp Street Psychiatry, PC Clinical CurrentSince Mar 4, 2022 Accepting new patients
Che Senior Psychological Services, PC Clinical CurrentSince Mar 4, 2022 Accepting new patients
Dr. Jennifer Wertovitch PSYD Psychologist PC CurrentSince Mar 14, 2025 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.

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

Verify at the official NPI Registry.