Michael L Nissnbaum, PH.D., Psychologist, P.C.
NPI 1205009511 · Psychologist · Stony Brook, NY
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Michael L Nissnbaum, PH.D., Psychologist, P.C. is a Psychologist organization in Stony Brook, NY (NPI 1205009511).
Provider details
- NPI number
- 1205009511
- Entity type
- Organization
- Primary specialty
- PsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Michael Nissenbaum, President(631) 737-9500
- License
- 010232 (NY)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2008-04-08
- Last updated
- 2008-07-01
Frequently asked questions
- What is Michael L Nissnbaum, PH.D., Psychologist, P.C.'s NPI number?
- Michael L Nissnbaum, PH.D., Psychologist, P.C.'s National Provider Identifier (NPI) is 1205009511, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Michael L Nissnbaum, PH.D., Psychologist, P.C.?
- Michael L Nissnbaum, PH.D., Psychologist, P.C. is classified in the NPPES registry as Psychologist (Behavioral Health & Social Service Providers).
- Where is Michael L Nissnbaum, PH.D., Psychologist, P.C. located?
- Michael L Nissnbaum, PH.D., Psychologist, P.C.'s practice location on file with NPPES is 4 Coed Ln, Stony Brook, NY 11790-2704.
- What is Michael L Nissnbaum, PH.D., Psychologist, P.C.'s phone number?
- The practice phone number listed in the NPPES registry for Michael L Nissnbaum, PH.D., Psychologist, P.C. is (631) 737-9500.
- Does Michael L Nissnbaum, PH.D., Psychologist, P.C. accept Medicare?
- Michael L Nissnbaum, PH.D., Psychologist, P.C. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Michael L Nissnbaum, PH.D., Psychologist, P.C.?
- The authorized official listed on Michael L Nissnbaum, PH.D., Psychologist, P.C.'s NPPES record is Michael Nissenbaum, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Michael L Nissnbaum, PH.D., Psychologist, P.C.'s NPI active?
- Yes — Michael L Nissnbaum, PH.D., Psychologist, P.C.'s NPI (1205009511) is active in the NPPES registry as of the last update on 2008-07-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.