Individual provider Active NPI

Brian Koehler, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1548468671
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7015 Issued in NY
Practice address
80 E 11TH St
#339
New York, NY 10003-6811
Phone
(212) 533-5687
NPI assigned
Jul 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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 7015 NY Primary

Addresses

Primary practice location

80 E 11TH St
#339
New York, NY 10003-6811

Mailing address

80 E 11TH St
#339
New York, NY 10003-6811
Phone (212) 533-5687

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
I20120117000309 NY Practitioner - Clinical Psychologist 7911174974 Practice locations: Hastings on Hudson, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

18 Nepperhan Ave
Hastings on Hudson, NY 10706-4015
Phone (914) 907-0715

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
7015NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1548468671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 E 11TH ST",
            "address_2": "#339",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100036811",
            "telephone_number": "212-533-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 E 11TH ST",
            "address_2": "#339",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100036811",
            "telephone_number": "212-533-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHLER",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "7015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.