Individual provider Active NPI

Deborah Ruth Birnbaum, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1821020165
Registry record updated Feb 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
010415 Issued in NY
Practice address
275 W 96TH St Apt 8Q
New York, NY 10025-6270
Phone
(212) 678-4758
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2008

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 010415 NY Primary

Addresses

Primary practice location

275 W 96TH St Apt 8Q
New York, NY 10025-6270

Mailing address

275 W 96TH St Apt 8Q
New York, NY 10025-6270
Phone (212) 678-4758

Other identifiers 1

IdentifierTypeStateIssuer
01430831MedicaidNY

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
I20070725000105 NY Practitioner - Clinical Psychologist 2365447554 Practice locations: Albany, NY; New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15 Stedman Way
Albany, NY 12211-1724
Phone (518) 269-0360

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203638400000",
    "number": "1821020165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W 96TH ST APT 8Q",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256270",
            "telephone_number": "212-678-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W 96TH ST APT 8Q",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256270",
            "telephone_number": "212-678-4758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRNBAUM",
        "first_name": "DEBORAH",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2008-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "010415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01430831",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.