Individual provider Active NPI

Mark Benisz, PSY.D.

  • Clinical Psychologist
  • New City, NY
National Provider Identifier
1831560010
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
021363 Issued in NY
Practice address
873 Route 45 Ste 204a
New City, NY 10956-1124
Phone
(845) 293-2345
NPI assigned
Oct 13, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 021363 NY
Clinical Psychologist 103TC0700X 021363 NY Primary

Addresses

Primary practice location

873 Route 45 Ste 204a
New City, NY 10956-1124

Mailing address

5 Deerwood Rd
Spring Valley, NY 10977-1002
Phone (845) 782-7510

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
I20231218002395 NY Practitioner - Clinical Psychologist 7012366974 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rockland Psychological Services PLLCGroup PAC ID 0547709578, 4 clinicians

Practice addresses (Care Compare)

978 Route 45
Suite 104
Pomona, NY 10970-3565
Phone (845) 738-8770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
021363NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Support LLC CurrentSince Jul 6, 2024 Accepting new patients
Rockland Psychological Services PLLC CurrentSince Jun 1, 2024 Accepting new patients
Medical Diagnostics of Rockland PC CurrentSince Nov 5, 2023 Accepting new patients

Locations

4403 15th Ave
Ste 499
Brooklyn, NY 11219
Phone (718) 400-9077

545 Broadway
Ste 2B
Brooklyn, NY 11206
Phone (718) 400-9077

491 State Route 208
Monroe, NY 10950
Phone (845) 977-4121

978 Route 45
Ste 104
Pomona, NY 10970
Phone (347) 897-5150

Networks

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1831560010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 DEERWOOD RD",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109771002",
            "telephone_number": "845-782-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "873 ROUTE 45 STE 204A",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109561124",
            "telephone_number": "845-293-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENISZ",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-13",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": "021363",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New City, NY

Sources for this page

Verify at the official NPI Registry.