Individual provider Active NPI

Jeffrey Fishberger, M.D.,

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1821014705
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
187421 Issued in NY
Practice address
1000 10TH Ave
St. Luke'S Roosevelt Hospital Center, Suite 2T
New York, NY 10019-1147
Phone
(212) 523-6500
Fax
(212) 523-7182
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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 187421 NY Primary

Addresses

Primary practice location

1000 10TH Ave
St. Luke'S Roosevelt Hospital Center, Suite 2T
New York, NY 10019-1147

Mailing address

PO Box 95000-2240
Philadelphia, PA 19195-0001
Phone (212) 523-6500

Other identifiers 1

IdentifierTypeStateIssuer
01774914MedicaidNY

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
I20090211000006 NY Practitioner - Psychiatry 4981769767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1425 Madison Ave
New York, NY 10029-6514
Phone (212) 824-8150

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2017 Accepting new patients

Locations

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

1000 10th Ave
Ste 2T
New York, NY 10019
Phone (212) 636-3600

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

1425 Madison Ave
New York, NY 10029
Phone (212) 824-8150

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1821014705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000-2240",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191950001",
            "telephone_number": "212-523-6500",
            "fax_number": "212-523-7182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 10TH AVE",
            "address_2": "ST. LUKE'S ROOSEVELT HOSPITAL CENTER, SUITE 2T",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191147",
            "telephone_number": "212-523-6500",
            "fax_number": "212-523-7182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHBERGER",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "187421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01774914",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.