Individual provider Active NPI

Marcia Brenner, EDD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1699823013
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
NYS PSY003626 Issued in NY
Practice address
255 West 88 Street
New York, NY 10024
Phone
(212) 873-6881
Fax
(212) 877-9709
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NYS PSY003626 NY Primary

Addresses

Primary practice location

255 West 88 Street
New York, NY 10024

Mailing address

255 West 88 Street
New York, NY 10024
Phone (212) 873-6881

Other identifiers 2

IdentifierTypeStateIssuer
144745OtherVALVE OPTIONS
0099553OtherGHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1964
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

255 W 88 St
New York, NY 10024

255 W 88TH St
14D
New York, NY 10024-1719

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NYS PSY003626NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ms Brenner Clin Psych PC Past Accepting new patients

Organizations & group practices 1

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699823013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 WEST 88 STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10024",
            "telephone_number": "212-873-6881",
            "fax_number": "212-877-9709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 WEST 88 STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10024",
            "telephone_number": "212-873-6881",
            "fax_number": "212-877-9709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNER",
        "first_name": "MARCIA",
        "name_prefix": "Dr.",
        "credential": "EDD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "NYS PSY003626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALVE OPTIONS",
            "identifier": "144745",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0099553",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.