Individual provider Active NPI

Robert M Morrison, PSY.D.

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1710101647
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
014325-1 Issued in NY
Practice address
2747 Coney Island Ave
Brooklyn, NY 11235-5004
Phone
(917) 586-5652
Fax
(718) 450-3206
NPI assigned
Apr 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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 014325-1 NY Primary

Addresses

Primary practice location

2747 Coney Island Ave
Brooklyn, NY 11235-5004

Mailing address

10 Forest Ave
Bridgewater, NJ 08807-3720
Phone (908) 377-3105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050315000458 NJ Practitioner - Clinical Psychologist 1951356781 Practice locations: Bridgewater, NJ
I20161108000266 NY Practitioner - Clinical Psychologist 1951356781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Skies Psychological Services, P.C.Group PAC ID 9638601933, 2 clinicians

Practice addresses (Care Compare)

710 Forest Ave
Suite 1
Staten Island, NY 10310-2522
Phone (347) 464-5550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014325-1NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Skies Psychological Services, P.C. Clinical CurrentSince Sep 20, 2024 Accepting new patients
Vericare Behavioral Health of New Jersey, P.a. Clinical Past Accepting new patients
Kevin T Custis M D P C Past Accepting new patients

Locations

710 Forest Ave
Ste 1
Staten Island, NY 10310
Phone (347) 464-5550

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1710101647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 FOREST AVE",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088073720",
            "telephone_number": "908-377-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2747 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355004",
            "telephone_number": "917-586-5652",
            "fax_number": "718-450-3206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISON",
        "first_name": "ROBERT",
        "middle_name": "M",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "014325-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.