Individual provider Active NPI

James Michael Bercovitz, PSY.D.

  • Clinical Psychologist
  • Oneonta, NY
National Provider Identifier
1821148289
Registry record updated Oct 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
011359 Issued in NY
Practice address
189 Main St Ste 203
Oneonta, NY 13820-2580
Phone
(607) 436-9159
NPI assigned
Jan 10, 2007
Last updated
Oct 5, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 011359 NY
Clinical Psychologist 103TC0700X 011359 NY Primary

Addresses

Primary practice location

189 Main St Ste 203
Oneonta, NY 13820-2580

Mailing address

67 East St
Oneonta, NY 13820-1627
Phone (607) 436-9159

Other identifiers 1

IdentifierTypeStateIssuer
01603754MedicaidNY

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
I20110112000003 NY Practitioner - Clinical Psychologist 6507055290 Practice locations: Oneonta, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Albert Einstein College of Medicine of Yeshiva University, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

189 Main St
Oneonta, NY 13820-3510
Phone (607) 436-9159

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1821148289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 EAST ST",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "138201627",
            "telephone_number": "607-436-9159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 MAIN ST STE 203",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "138202580",
            "telephone_number": "607-436-9159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERCOVITZ",
        "first_name": "JAMES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "011359",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "011359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01603754",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oneonta, NY

Sources for this page

Verify at the official NPI Registry.