Individual provider Active NPI

Jack Schapiro, PSY.D.

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1578579140
Registry record updated Aug 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
014400 Issued in NY
Practice address
5110 12TH Ave
Brooklyn, NY 11219-3424
Phone
(800) 275-3243
Fax
(800) 275-3671
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2026

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 014400 NY Primary

Addresses

Primary practice location

5110 12TH Ave
Brooklyn, NY 11219-3424

Mailing address

600 W 111TH St Apt 7B1
New York, NY 10025-1813
Phone (914) 450-7254

Other identifiers 1

IdentifierTypeStateIssuer
02118894MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14000NYMDClinical Psychologist
014400NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Knapp Street Psychiatry, PC Clinical CurrentSince Jan 28, 2025 Accepting new patients
Clinical Psychassociates LLP Clinical Past Accepting new patients

Locations

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

5110 12th Ave
Brooklyn, NY 11219
Phone (718) 854-8370

2433 Knapp St
Ste 306
Brooklyn, NY 11235

1 Greenwich St
Hempstead, NY 11550
Phone (516) 365-1953

425 National Blvd
Long Beach, NY 11561
Phone (516) 353-3387

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

Organizations & group practices 2

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787443200000",
    "number": "1578579140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W 111TH ST APT 7B1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251813",
            "telephone_number": "914-450-7254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 12TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112193424",
            "telephone_number": "800-275-3243",
            "fax_number": "800-275-3671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAPIRO",
        "first_name": "JACK",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2026-08-23",
        "certification_date": "2026-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "014400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02118894",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.