Individual provider Active NPI

Bernard Victor Gertler, PHD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1801033535
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4992 Issued in NY
Practice address
147 W 79TH St Ste 1a
New York, NY 10024-6448
Phone
(212) 799-5816
NPI assigned
Jan 16, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

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 4992 NY Primary

Addresses

Primary practice location

147 W 79TH St Ste 1a
New York, NY 10024-6448

Mailing address

147 W 79TH St Ste 1a
New York, NY 10024-6448
Phone (212) 799-5816

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
I20150512001231 NY Practitioner - Clinical Psychologist 0042539181 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

147 W 79TH St
1A
New York, NY 10024-6448
Phone (212) 799-5816

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4992NYMDClinical Psychologist
004992NYMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232064000000",
    "number": "1801033535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 W 79TH ST STE 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246448",
            "telephone_number": "212-799-5816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 W 79TH ST STE 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246448",
            "telephone_number": "212-799-5816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERTLER",
        "first_name": "BERNARD",
        "middle_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-16",
        "last_updated": "2009-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "4992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.