Individual provider Active NPI

Benjamin Kerman, PH.D.

  • Clinical Psychologist
  • Eden, NY
National Provider Identifier
1609927946
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
024382 Issued in NY
Practice address
3457 E Church St
Eden, NY 14057-9583
Phone
(203) 305-6379
NPI assigned
Jan 15, 2007
Last updated
Sep 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 002139 CT
Clinical Psychologist 103TC0700X 024382 NY Primary
Clinical Child & Adolescent Psychologist 103TC2200X 024382 NY
Clinical Child & Adolescent Psychologist 103TC2200X 002139 CT

Addresses

Primary practice location

3457 E Church St
Eden, NY 14057-9583

Mailing address

3457 E Church St
Eden, NY 14057-9583
Phone (203) 305-6379

Other practice location 1

37 Windsor Ave
Buffalo, NY 14209-1038
Phone (203) 305-6379

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
024382NYMDClinical Psychologist
002139CTMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1609927946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3457 E CHURCH ST",
            "city": "EDEN",
            "state": "NY",
            "postal_code": "140579583",
            "telephone_number": "203-305-6379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3457 E CHURCH ST",
            "city": "EDEN",
            "state": "NY",
            "postal_code": "140579583",
            "telephone_number": "203-305-6379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37 Windsor Ave",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142091038",
            "country_code": "US",
            "telephone_number": "203-305-6379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERMAN",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002139",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024382",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "024382",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CT",
            "license": "002139",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.