Individual provider Active NPI

Michael Bernstein, M.D.

  • Psychiatry Physician
  • South Ozone Park, NY
National Provider Identifier
1689685380
Registry record updated Jun 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
00176392 Issued in NY
Practice address
10819 Rockaway Blvd
South Ozone Park, NY 11420-1034
Phone
(718) 845-2620
Fax
(718) 845-9380
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 00176392 NY Primary

Addresses

Primary practice location

10819 Rockaway Blvd
South Ozone Park, NY 11420-1034

Mailing address

120 Hards LN
Lawrence, NY 11559-1315
Phone (718) 845-2620

Other identifiers 1

IdentifierTypeStateIssuer
00176392MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050406001108 NY Practitioner - Psychiatry 3072560572 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00176392NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Horizon Counseling Center Inc CurrentSince Nov 22, 1996 Accepting new patients
Michael Bernstein MDPC Psychiatry CurrentSince Jul 5, 2012 Accepting new patients

Locations

10819 Rockaway Blvd
South Ozone Park, NY 11420
Phone (718) 327-7202

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244419200000",
    "number": "1689685380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HARDS LN",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591315",
            "telephone_number": "718-845-2620",
            "fax_number": "718-845-9380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10819 ROCKAWAY BLVD",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114201034",
            "telephone_number": "718-845-2620",
            "fax_number": "718-845-9380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNSTEIN",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2009-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "00176392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00176392",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Ozone Park, NY

Sources for this page

Verify at the official NPI Registry.