Active NPI
Sergei Tsytsarev, PH.D.
- Family Psychologist
- Brooklyn, NY
National Provider Identifier
1649323023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Psychologist
- License
- 013502
- Practice address
- 2327 83Rd St
Suite D
Brooklyn, NY 11214-2750 - Phone
- (718) 236-0700
- Fax
- (718) 232-2625
- NPI assigned
- Jan 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 013502 | NY | |
| Family Psychologist | 103TF0000X | 013502 | NY | Primary |
Addresses
Primary practice location
2327 83Rd St
Suite D
Brooklyn, NY 11214-2750
Mailing address
2 Ridge Dr
Glen Cove, NY 11542-3233
Phone (516) 676-2525
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01942841 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013502 | NY | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203984000000",
"number": "1649323023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 RIDGE DR",
"city": "GLEN COVE",
"state": "NY",
"postal_code": "115423233",
"telephone_number": "516-676-2525",
"fax_number": "516-676-2525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2327 83RD ST",
"address_2": "SUITE D",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112142750",
"telephone_number": "718-236-0700",
"fax_number": "718-232-2625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TSYTSAREV",
"first_name": "SERGEI",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-19",
"last_updated": "2008-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "013502",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "NY",
"license": "013502",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01942841",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.