Michael Indenbaum Rodriguez, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

024679 Issued in NY

Practice address

167 Madison Ave Suite 205 1004
New York, NY 10016

Phone

(929) 244-0018

NPI assigned

May 1, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Nyc Psychiatrist Services P.C.

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1598236283
  NPD (past)

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

{
    "created_epoch": "1588291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1871114710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 MADISON AVE RM 205 #1004",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165403",
            "telephone_number": "929-244-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 MADISON AVE SUITE 205 1004",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "929-244-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MICHAEL",
        "middle_name": "INDENBAUM",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-01",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "024679",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NY",
            "license": "024679",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NY",
            "license": "024679",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Antonia Rodriguez
• Maria Christina Rodriguez, P.T.
• Maria Milagros Rodriguez, OD
• Megan Margarita Rodriguez, MD
• Michael Brendan Rodriguez, PT, DPT
• Michelle Rodriguez
• Michelle C Rodriguez, MPT, OCS, CMPT
• Michelle Esther Rodriguez, PA-C
• Miguel Rodriguez
• Miguel Anthony Rodriguez, LCSW

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.