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ETHAN BARDELL
NPI 1215583067
Counselor in Cortland, NY

Active since August 16, 2019PECOS EnrolledAccepts Medicare Assignment
165 MAIN ST, STE A, CORTLAND, NY 13045(607) 753-0234 Get Directions Write a Review

NPPES record last updated: August 16, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Ethan Bardell NPPES

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

ETHAN BARDELL (NPI 1215583067) is an individual counselor in Cortland, New York, licensed in New York (101837) and active in the NPI registry since August 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1215583067
Entity TypeIndividualMale
Primary Taxonomy101Y00000X
Provider Legal NameETHAN BARDELL
Location Address165 MAIN ST, STE ACortland, NY 13045-3049
Mailing Address165 Main St, Ste ACortland, NY 13045-3049 · (607) 753-0234
Phone(607) 753-0234
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateAugust 16, 2019
✔ NPI 1215583067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in NY · 101837
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
165 MAIN ST, Cortland, NY 13045
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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

Ethan Bardell 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 ID4385096866
PECOS Enrollment IDI20240119003247
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 Ethan Bardell reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mccd Psychiatry Services PLLC
171 mi
Psychiatry
109 W 27TH ST # 5S
New York, NY 10001
  • Reassigned Medicare billing, New York enrollment
  • 590 clinicians in this Medicare group
NPI 1033750823 (917) 634-5311

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 20

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

CHARLOTTE SWEENEY LCSW
Counselor
165 MAIN ST, STE A
CORTLAND, NY 13045
Cortland County (607) 753-0234
PAMELA LYNN SANDERS LCSW
Social Worker (Clinical)
165 MAIN ST, STE A
CORTLAND, NY 13045
Cortland County (607) 753-0234
STEFANIE FELLOWS
Counselor
165 MAIN ST, STE A
CORTLAND, NY 13045
Cortland County (607) 753-0234
LISA STOOTHOFF
Student in an Organized Health Care Education/Training Program
165 MAIN ST, STE A
CORTLAND, NY 13045
Cortland County (607) 753-0234
ALEXANDRA MIKOWSKI
Counselor
165 MAIN ST, STE A
CORTLAND, NY 13045
Cortland County (607) 753-0234
MICHAEL JOHNSON
Peer Specialist
165 MAIN ST, STE A
CORTLAND, NY 13045
Cortland County (607) 753-0234
MALIA ROGERS MHC-LP
Counselor
165 MAIN ST, STE A
CORTLAND, NY 13045
Cortland County (607) 753-0234
RINI SIMON CHENNATTU PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
165 MAIN ST
CORTLAND, NY 13045
Cortland County (845) 536-0732

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 Ethan Bardell's NPI number?

The NPI number for Ethan Bardell is 1215583067. It was assigned to this individual provider in the NPPES registry on August 16, 2019.

Where is Ethan Bardell located?

Ethan Bardell practices at 165 Main St Ste A, Cortland, NY 13045. The listed phone number is (607) 753-0234.

What is Ethan Bardell's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Ethan Bardell enrolled in Medicare?

Yes. Ethan Bardell 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 Ethan Bardell's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ethan Bardell reassigns Medicare benefits to Mccd Psychiatry Services PLLC (New York, 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 Ethan Bardell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Ethan Bardell was last updated on August 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.