Individual provider Active NPI

Abraham Eliot Kirschenbaum, PSY.D.

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1760423305
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
011977 Issued in NY
Practice address
18 Middleton St
Brooklyn, NY 11206-5415
Phone
(718) 875-6900
Fax
(718) 875-3282
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2012

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 011977 NY Primary

Addresses

Primary practice location

18 Middleton St
Brooklyn, NY 11206-5415

Mailing address

18 Middleton St
Brooklyn, NY 11206-5415
Phone (718) 875-6900

Other identifiers 1

IdentifierTypeStateIssuer
0518029MedicaidNY

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
I20120113000721 NY Practitioner - Clinical Psychologist 7113194119 Reassigns benefits to 1 organization
Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pesach Tikvah Hope Development IncGroup PAC ID 2163311564, 44 clinicians

Practice addresses (Care Compare)

4111 18TH Ave
Brooklyn, NY 11218-5894
Phone (718) 875-6900

5309 18TH Ave
Brooklyn, NY 11204-1523
Phone (718) 705-5190

926 Bedford Ave
Brooklyn, NY 11205-3913
Phone (718) 875-6900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011977NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pesach Tikvah Hope Development Inc Current Accepting new patients
Pesach Tikvah Hope Development Inc CurrentSince Jan 1, 1992 Accepting new patients

Locations

365 Willoughby Ave
Ste 400
Brooklyn, NY 11205

5309 18th Ave
Brooklyn, NY 11204
Phone (718) 705-5190

18 Middleton St
Brooklyn, NY 11206
Phone (718) 875-6993

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329696000000",
    "number": "1760423305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 MIDDLETON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112065415",
            "telephone_number": "718-875-6900",
            "fax_number": "718-875-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 MIDDLETON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112065415",
            "telephone_number": "718-875-6900",
            "fax_number": "718-875-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSCHENBAUM",
        "first_name": "ABRAHAM",
        "middle_name": "ELIOT",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2012-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "011977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0518029",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.