Individual provider Active NPI

Michael Thomas Gilbride, MA MS ADV CERT

  • School Psychologist
  • Brooklyn, NY
National Provider Identifier
1922282698
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
2829 Issued in PR
Practice address
9707 4TH Ave Apt 1L
Brooklyn, NY 11209-8128
Phone
(917) 331-5116
NPI assigned
Dec 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X NY
School Psychologist 103TS0200X 2829 PR Primary

Addresses

Primary practice location

9707 4TH Ave Apt 1L
Brooklyn, NY 11209-8128

Mailing address

9707 4TH Ave Apt 1L
Brooklyn, NY 11209-8128
Phone (917) 331-5116

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
Master of Arts, Master of Science

State licenses

LicenseStateTypeSpecialty
2829PRMDMedical Laboratory Technician

NPI Registry JSON

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1922282698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9707 4TH AVE APT 1L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112098128",
            "telephone_number": "917-331-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9707 4TH AVE APT 1L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112098128",
            "telephone_number": "917-331-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBRIDE",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "credential": "MA MS ADV CERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-18",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "PR",
            "license": "2829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.