Individual provider Active NPI

Simon A. Rego, PSYD, ABPP, ACT

  • Psychologist
  • Bronx, NY
National Provider Identifier
1699845800
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
015781 Issued in NY
Practice address
111 E 210TH St
Psychiatry
Bronx, NY 10467-2401
Phone
(718) 920-5024
Fax
(718) 798-1816
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 015781 NY Primary

Addresses

Primary practice location

111 E 210TH St
Psychiatry
Bronx, NY 10467-2401

Mailing address

111 E 210TH St
Psychiatry
Bronx, NY 10467-2401
Phone (718) 920-5024

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080118000077 NY Practitioner - Clinical Psychologist 0345321147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015781NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Dec 18, 2020 Accepting new patients
Montefiore Medical Center CurrentSince Dec 18, 2020 Accepting new patients
Dr Robert L Leahy Psychologist PC Dba American Institute for Cognitiv Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

3317 Rochambeau Ave
Bronx, NY 10467
Phone (718) 920-4797

136 E 57th St
Ste 1101
New York, NY 10022
Phone (212) 308-2440

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 3

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305763200000",
    "number": "1699845800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "address_2": "PSYCHIATRY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-5024",
            "fax_number": "718-798-1816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "address_2": "PSYCHIATRY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-5024",
            "fax_number": "718-798-1816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGO",
        "first_name": "SIMON",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PSYD, ABPP, ACT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2011-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "015781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.