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DR. MICHAEL LEONARD NISSENBAUM PH.D.
NPI 1174546725
Psychologist - Cognitive & Behavioral in Centereach, NY

Active since July 25, 2006PECOS EnrolledAccepts Medicare Assignment
2100 MIDDLE COUNTRY RD, SUITE 28W, CENTEREACH, NY 11720(631) 737-9500(631) 737-9512 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Michael Leonard Nissenbaum Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MICHAEL LEONARD NISSENBAUM PH.D. (NPI 1174546725) is an individual cognitive & behavioral provider in Centereach, New York, licensed in New York (010232) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1988).

NPPES Registry Identity

NPI1174546725
Entity TypeIndividualMale
Primary Taxonomy103TB0200X
Provider Legal NameDR. MICHAEL LEONARD NISSENBAUMCredential: PH.D.
Location Address2100 MIDDLE COUNTRY RD, SUITE 28WCentereach, NY 11720-3577
Mailing AddressPo Box 625Centereach, NY 11720-0625 · (631) 737-9500 · Fax (631) 737-9512
Phone(631) 737-9500
Fax(631) 737-9512
Sole ProprietorYes
Medical School CMSOtherGraduated 1988
Enumeration DateJuly 25, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1174546725 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Cognitive & BehavioralBehavioral Health & Social Service Providers
Taxonomy Code103TB0200X
License✔ Licensed in NY · 010232
Definition
A psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking.
2100 MIDDLE COUNTRY RD, Centereach, NY 11720
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Other Identifiers 2

Medicare ID-Type UnspecifiedV71171NY · Provider Number
Medicare UPINR-53044NY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Michael Leonard Nissenbaum Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2264336296
PECOS Enrollment IDI20031121000443
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Michael Nissenbaum reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Michael L Nissnbaum, Ph.D., Psychologist, P.C.
3.2 mi
Psychologist
4 COED LN
Stony Brook, NY 11790
  • Reassigned Medicare billing, New York enrollment
NPI 1205009511 (631) 737-9500

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HONEST PHYSICAL THERAPY PLLC
Physical Therapist (Orthopedic)
2100 MIDDLE COUNTRY RD, SUITE 17 LOWER LEVEL
CENTEREACH, NY 11720
Suffolk County (631) 504-0680
AIMEE WERNER
Physical Therapist
2100 MIDDLE COUNTRY RD
CENTEREACH, NY 11720
Suffolk County (631) 580-2526
MR. MATTHEW ROBERT FALLON
Rehabilitation Hospital
2100 MIDDLE COUNTRY RD
CENTEREACH, NY 11720
Suffolk County (631) 580-2526
MR. GREGG W. DIPRIMA II P.T.
Physical Therapist
2100 MIDDLE COUNTRY RD
CENTEREACH, NY 11720
Suffolk County (631) 580-2526
JACQUELINE MOCKLER DPT
Physical Therapist
2100 MIDDLE COUNTRY RD
CENTEREACH, NY 11720
Suffolk County (631) 580-2526
JULIA STEIGER
Counselor
2100 MIDDLE COUNTRY RD
CENTEREACH, NY 11720
Suffolk County (631) 468-8587
COLLEEN MARIE MURPHY P.T., D.P.T.
Physical Therapist
2100 MIDDLE COUNTRY RD
CENTEREACH, NY 11720
Suffolk County (631) 580-2526
DR. NICHOLAS DEMARCO PT, DPT
Physical Therapist
2100 MIDDLE COUNTRY RD
CENTEREACH, NY 11720
Suffolk County (631) 580-2526

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Nissenbaum's NPI number?

The NPI number for Michael Nissenbaum is 1174546725. It was assigned to this individual provider in the NPPES registry on July 25, 2006.

Where is Michael Nissenbaum located?

Michael Nissenbaum practices at 2100 Middle Country Rd Suite 28W, Centereach, NY 11720. The listed phone number is (631) 737-9500.

What is Michael Nissenbaum's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Cognitive & Behavioral, with taxonomy code 103TB0200X.

Is Michael Nissenbaum enrolled in Medicare?

Yes. Michael Nissenbaum is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Michael Nissenbaum's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Nissenbaum reassigns Medicare benefits to Michael L Nissnbaum, Ph.D., Psychologist, P.C. (Stony Brook, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Michael Nissenbaum's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Michael Nissenbaum accept?

Health plans from Oscar Health list Michael Nissenbaum as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Michael Nissenbaum was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.