Manuel Lopez-Leon, MD

Individual provider Active NPI Psychiatry Physician · New York, NY

NPI 1629035985 · NPPES record last updated Mar 1, 2012

Key facts

NPI
1629035985
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatry Physician 2084P0800X
License
246497 (NY)
Practice address
169 East 74TH Street
New York, NY 10021
Phone
(212) 260-1438
Fax
(212) 228-3290
NPI assigned
Apr 28, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 7

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.

Medicare Care Compare profile

Specialty
Psychiatry
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brooklyn Center for Families in Crisis (9 clinicians)

Practice addresses (Care Compare)

1309 -1311 Foster Ave
Brooklyn, NY 11230-1511
Phone (718) 282-0010

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20090328000002 NY Practitioner - Psychiatry 3476538307 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Brookdale Hospital Medical Center Current
since Nov 22, 2016
Accepting new patients
Jewish Board of Family & Childrens Services Inc Current Accepting new patients
Jewish Board of Family and Children'S Services, Inc. Current
since Jun 1, 2015
Accepting new patients
Jewish Board of Family and Children'S Services, Inc Current
since Jun 1, 2015
Accepting new patients
The Brookdale Hospital Medical Center Current
since Nov 22, 2016
Accepting new patients
Brooklyn Center for Families in Crisis Current
since Jan 1, 2012
Accepting new patients
Everly, Hildreth & Platman Behavioral Services, LLC Psychiatry Past Accepting new patients

Locations

3600 Jerome Ave
Bronx, NY 10467
Phone (718) 366-8400

938 Kings Hwy
Brooklyn, NY 11223
Phone (718) 998-3235

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 246497 NY Yes

Addresses

Primary practice location

169 East 74TH Street
New York, NY 10021

Mailing address

169 E 74TH St
New York, NY 10021-3222
Phone (212) 260-1438

Other providers in New York, NY

All providers in New York, NY · Psychiatry Physician in New York

Sources for this page

Verify at the official NPI Registry.