Individual provider Active NPI

Ira S Gershansky, PHD

  • Psychologist
  • Staten Island, NY
National Provider Identifier
1891701660
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
009962-1 Issued in NY
Practice address
55 Nelson Ave
Staten Island, NY 10308-2706
Phone
(718) 317-6756
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 009962-1 NY Primary

Addresses

Primary practice location

55 Nelson Ave
Staten Island, NY 10308-2706

Mailing address

55 Nelson Ave
Staten Island, NY 10308-2706
Phone (718) 317-6756

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
I20110322000236 NY Practitioner - Clinical Psychologist 0244413771 Practice locations: Staten Island, NY

Care Compare profile

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

Practice addresses (Care Compare)

800 Annadale Rd
Staten Island, NY 10312-3102
Phone (718) 317-6756

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009962-1NYMDPsychologist
009962NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891701660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 NELSON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103082706",
            "telephone_number": "718-317-6756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 NELSON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103082706",
            "telephone_number": "718-317-6756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSHANSKY",
        "first_name": "IRA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "009962-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.