Organization Active NPI

Pearl Behavioral Health & Medicine PLLC

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1629581822
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PEARL BEHAVIORAL HEALTH & MEDICINE PLLC
Practice address
387 Park Ave S FL 5
New York, NY 10016-8810
Phone
(347) 916-4944
NPI assigned
Nov 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Authorized official

Name
Gabriella Inczedy Farkas, MD
Title
Owner
Phone
(347) 916-4944

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

387 Park Ave S FL 5
New York, NY 10016-8810

Mailing address

387 Park Ave S FL 5
New York, NY 10016-8810
Phone (347) 916-4944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190624000376 NY Part B Supplier - Clinic/Group Practice 8628302783 Practice locations: Long Island City, NY
O20230626000143 SC Part B Supplier - Clinic/Group Practice 8628302783 Practice locations: Hilton Head Island, SC

National Provider Directory

National Provider Directory

Locations

3245 Hunters Point Ave
Long Island City, NY 11101
Phone (917) 267-9678

NPI Registry JSON

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560729600000",
    "number": "1629581822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 PARK AVE S FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100168810",
            "telephone_number": "347-916-4944",
            "fax_number": "347-983-7244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 PARK AVE S FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100168810",
            "telephone_number": "347-916-4944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARL BEHAVIORAL HEALTH & MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-09",
        "last_updated": "2019-06-17",
        "status": "A",
        "authorized_official_last_name": "INCZEDY FARKAS",
        "authorized_official_first_name": "GABRIELLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-916-4944",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.