Individual provider Active NPI

Harold Bronheim, M.D.

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1790773372
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
146373 Issued in NY
Practice address
1155 Park Ave
New York, NY 10128-1209
Phone
(212) 996-5777
NPI assigned
Oct 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 146373 NY Primary

Addresses

Primary practice location

1155 Park Ave
New York, NY 10128-1209

Mailing address

1155 Park Ave
New York, NY 10128-1209

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140501001387 NY Order and Referring Only - Geriatric MedicinePractitioner - Geriatric PsychiatryPractitioner - Geriatric Medicine 1456584259

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
146373NYMDPsychiatry Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1790773372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281209",
            "telephone_number": "212-996-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONHEIM",
        "first_name": "HAROLD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-08",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "146373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.