Individual provider Active NPI

Joseph Underberg

  • Mental Health Counselor
  • New York, NY
National Provider Identifier
1750848545
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P14889 Issued in NY
Practice address
124 W 79TH St Apt 1B
New York, NY 10024-6488
Phone
(212) 362-0528
NPI assigned
Feb 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P14889 NY Primary

Addresses

Primary practice location

124 W 79TH St Apt 1B
New York, NY 10024-6488

Mailing address

124 W 79TH St Apt 1B
New York, NY 10024-6488

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
I20240905000294 NY Practitioner - Mental Health Counselor 4486194479 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P14889NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New York Foundling Current Accepting new patients
The New York Foundling Hospital CurrentSince Jun 20, 2024 Accepting new patients
New York Foundling CurrentSince Jun 20, 2024 Accepting new patients

Locations

170 Brown Pl
Bronx, NY 10454
Phone (212) 206-7140

590 Ave of the Americas
Fl 10
New York, NY 10011

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": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1750848545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 W 79TH ST APT 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 W 79TH ST APT 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246488",
            "telephone_number": "212-362-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERBERG",
        "first_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-27",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P14889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.