Active NPI
Jessica R Benjamin, PH.D.
- Psychoanalysis Psychologist
- New York, NY
National Provider Identifier
1902335474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychoanalysis Psychologist
- License
- 000704
- Practice address
- 215 W 95TH St Apt 5G
New York, NY 10025-6353 - Phone
- (212) 874-0490
- Fax
- (212) 874-0490
- NPI assigned
- Jun 8, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychoanalysis Psychologist | 103TP0814X | 000704 | NY | Primary |
Addresses
Primary practice location
215 W 95TH St Apt 5G
New York, NY 10025-6353
Mailing address
243 Riverside Dr Apt 1202
New York, NY 10025-8647
Phone (212) 874-0490
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000704 | Other | NY | NEW YORK STATE BOARD OF CERTIFICATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000704 | NY | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496880000000",
"number": "1902335474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "243 RIVERSIDE DR APT 1202",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100258647",
"telephone_number": "212-874-0490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 W 95TH ST APT 5G",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100256353",
"telephone_number": "212-874-0490",
"fax_number": "212-874-0490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENJAMIN",
"first_name": "JESSICA",
"middle_name": "R",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-08",
"last_updated": "2017-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TP0814X",
"taxonomy_group": "",
"desc": "Psychologist, Psychoanalysis",
"state": "NY",
"license": "000704",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW YORK STATE BOARD OF CERTIFICATION",
"identifier": "000704",
"state": "NY"
}
],
"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 Jun 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.