Individual provider Active NPI

James Herivaux, MD

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1891711172
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
194186 Issued in NY
Practice address
416 E 76TH St
4TH Floor
New York, NY 10021-3104
Phone
(212) 434-5393
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 194186 NY Primary

Addresses

Primary practice location

416 E 76TH St
4TH Floor
New York, NY 10021-3104

Mailing address

416 E 76TH St
4TH Floor
New York, NY 10021-3104
Phone (212) 434-5393

Other identifiers 1

IdentifierTypeStateIssuer
01890775MedicaidNY

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040622001144 NY Practitioner - Psychiatry 7315922457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1989
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
New York Psychotherapy and Counseling CenterGroup PAC ID 4880600147, 113 clinicians

Practice addresses (Care Compare)

2857 Linden Blvd
Brooklyn, NY 11208-5126
Phone (718) 235-3100

579 Courtlandt Ave
Bronx, NY 10451-5013
Phone (718) 485-2100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York Psychotherapy and Counseling Center CurrentSince Oct 14, 2013 Accepting new patients
Institute for the Puerto Rican Hispanic Elderly Inc. Past Accepting new patients
Service Program for Older People, Inc PastSince Jul 6, 2009 Accepting new patients
Under Angel'S Wings Recovery Center, LLC Past Accepting new patients
Welllife Network Inc Past Accepting new patients
Park Slope Center for Mental Health, Inc PastSince Oct 11, 2005 Accepting new patients
Service Program for Older People Past Accepting new patients
Welllife Network Inc. Past Accepting new patients
Samuel Field Ym&Ywha Past Accepting new patients
East Side Medical and Diagnostics Services, PC Psychiatry Past Accepting new patients

Locations

102 Pilling St
Brooklyn, NY 11207
Phone (718) 602-1000

2857 Linden Blvd
Brooklyn, NY 11208
Phone (718) 235-3100

17620 148th Ave
Jamaica, NY 11434
Phone (718) 553-1100

Organizations & group practices 10

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1891711172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 E 76TH ST",
            "address_2": "4TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213104",
            "telephone_number": "212-434-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 E 76TH ST",
            "address_2": "4TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213104",
            "telephone_number": "212-434-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERIVAUX",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "194186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01890775",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.