Individual provider Active NPI

Brianne M Gruber Wiener, PSY.D.

  • Clinical Child & Adolescent Psychologist
  • Mineola, NY
National Provider Identifier
1902158827
Registry record updated Oct 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
020209 Issued in NY
Practice address
120 Mineola Blvd
Suite 460
Mineola, NY 11501-4064
Phone
(516) 663-9400
Fax
(516) 663-9480
NPI assigned
Oct 3, 2012
Last updated
Oct 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X P85548 NY
Clinical Child & Adolescent Psychologist 103TC2200X 020209 NY Primary

Addresses

Primary practice location

120 Mineola Blvd
Suite 460
Mineola, NY 11501-4064

Mailing address

120 Mineola Blvd
Suite 460
Mineola, NY 11501-4064
Phone (516) 663-9400

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
I20260122000604 NY Practitioner - Clinical Psychologist 4880171743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Park Ave FL
Suite 11
New York, NY 10016-5818

700 Hicksville Rd
Bethpage, NY 11714-3471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P85548NYMDPsychologist
020209NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jan 15, 2026 Accepting new patients
New York University CurrentSince Jan 15, 2026 Accepting new patients

Locations

120 Mineola Blvd
Ste 460
Mineola, NY 11501
Phone (516) 663-9400

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792713600000",
    "number": "1902158827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MINEOLA BLVD",
            "address_2": "SUITE 460",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014064",
            "telephone_number": "516-663-9400",
            "fax_number": "516-663-9480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MINEOLA BLVD",
            "address_2": "SUITE 460",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014064",
            "telephone_number": "516-663-9400",
            "fax_number": "516-663-9480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBER WIENER",
        "first_name": "BRIANNE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-03",
        "last_updated": "2026-10-23",
        "certification_date": "2026-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "P85548",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "020209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.