Active NPI
Robert James Penzer, M.D.
- Psychiatry Physician
- New York, NY
National Provider Identifier
1871658617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 171637
- Practice address
- 211 Central Park W
Suite 1K
New York, NY 10024-6020 - Phone
- (212) 987-5066
- NPI assigned
- Dec 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 171637 | NY | Primary |
Addresses
Primary practice location
211 Central Park W
Suite 1K
New York, NY 10024-6020
Mailing address
211 Central Park W
Suite 1K
New York, NY 10024-6020
Phone (212) 987-5066
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 2, 2022 through Mar 2, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 171637 | NY | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222819200000",
"number": "1871658617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 CENTRAL PARK W",
"address_2": "SUITE 1K",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100246020",
"telephone_number": "212-987-5066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 CENTRAL PARK W",
"address_2": "SUITE 1K",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100246020",
"telephone_number": "212-987-5066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENZER",
"first_name": "ROBERT",
"middle_name": "JAMES",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-22",
"last_updated": "2008-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "171637",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.