Active NPI
Matthew Berler, PSYD
- Student in an Organized Health Care Education/Training Program
- New York, NY
National Provider Identifier
1912536087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 41 Union SQ W Ste 707
New York, NY 10003-3230 - Phone
- (917) 310-4798
- NPI assigned
- Apr 2, 2020
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 024228 | NY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary | ||
| Psychologist | 103T00000X | 024228 | NY |
Addresses
Primary practice location
41 Union SQ W Ste 707
New York, NY 10003-3230
Mailing address
41 Union SQ W Ste 707
New York, NY 10003-3230
Phone (917) 310-4798
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 11, 2021 through May 11, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618617600000",
"number": "1912536087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 UNION SQ W STE 707",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100033230",
"telephone_number": "917-310-4798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 UNION SQ W STE 707",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100033230",
"telephone_number": "917-310-4798"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERLER",
"first_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-04-02",
"last_updated": "2021-04-17",
"certification_date": "2021-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "024228",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "024228",
"primary": false
}
],
"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 Apr 17, 2021; 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.