Dr Michael Leonard Nissenbaum, PHD is a medicare enrolled "Psychologist - Cognitive & Behavioral" provider in Centereach, New York. He graduated from medical school in 1988 and has 38 years of diverse experience with area of expertise as Clinical Psychologist. His current practice location is
2100 Middle Country Rd, Suite 28w, Centereach, New York. You can reach out to his office (for appointments etc.) via phone at
(631) 737-9500.
Dr Michael Leonard Nissenbaum is licensed to practice in New York (license number 010232) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1174546725.
Healthcare Provider's Profile
| Full Name | Dr Michael Leonard Nissenbaum |
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| Gender | Male |
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| Speciality | Clinical Psychologist |
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| Experience | 38 Years |
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| Location | 2100 Middle Country Rd, Centereach, New York |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Michael Leonard Nissenbaum graduated from medical school in 1988
NPI Data:
- NPI Number: 1174546725
- Provider Enumeration Date: 07/25/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 2264336296
- Enrollment ID: I20031121000443
Medical Identifiers
Medical identifiers for Dr Michael Leonard Nissenbaum such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1174546725 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103TB0200X | Psychologist - Cognitive & Behavioral | 010232 (New York) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Michael Leonard Nissenbaum allows following entities to bill medicare on his behalf.
| Entity Name | Michael L Nissnbaum, Ph.d., Psychologist, P.c. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1205009511
PECOS PAC ID: 2062591902
Enrollment ID: O20080505000295 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Michael Leonard Nissenbaum is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Michael Leonard Nissenbaum, PHD
Po Box 625,
Centereach, NY 11720-0625
Ph: (631) 737-9500 | Dr Michael Leonard Nissenbaum, PHD
2100 Middle Country Rd, Suite 28w,
Centereach, NY 11720-3577
Ph: (631) 737-9500 |
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