JONATHAN FADER PHD
NPI 1710971064
Psychologist - Clinical in New York, NY

Q: What is Jonathan Fader's NPI number?

The NPI number for Jonathan Fader is 1710971064. It was assigned to this individual provider in the NPPES registry on September 1, 2005.

Q: What is Jonathan Fader's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: Is Jonathan Fader enrolled in Medicare?

No. Jonathan Fader has opted out of Medicare through May 22, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Jonathan Fader was last updated on February 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since September 01, 2005Opted out of Medicare · through May 22, 2028

138 W 25TH ST FL 10, NEW YORK, NY 10001(212) 335-2100(646) 775-4142 Get Directions Write a Review

NPPES record last updated: February 14, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Jonathan Fader Phd NPPES

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

JONATHAN FADER PHD (NPI 1710971064) is an individual clinical provider in New York, New York, licensed in New York (016156) and active in the NPI registry since September 2005. He has opted out of Medicare through May 22, 2028.

NPPES Registry Identity

NPI1710971064

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameJONATHAN FADERCredential: PHD

Location Address138 W 25TH ST FL 10New York, NY 10001-7470

Mailing Address138 W 25th St Fl 10New York, NY 10001-7470 · (212) 335-2100 · Fax (646) 775-4142

Phone(212) 335-2100

Fax(646) 775-4142

Sole ProprietorNo

Enumeration DateSeptember 1, 2005

Last NPPES UpdateFebruary 14, 2021

NPPES CertifiedFebruary 14, 2021

✔ NPI 1710971064 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in NY · 016156

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

138 W 25TH ST FL 10, New York, NY 10001

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Jonathan Fader Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 22, 2018 through May 22, 2028.

Opt-Out Effective DateMay 22, 2018

Opt-Out In Effect ThroughMay 22, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10001 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$198.19 typical visit price

range $65.69 – $198.19

Typical copayment $49.54 (range $16.42 – $49.54)

Most-billed visit code 99205

Established Patient

$114.88 typical visit price

range $21.20 – $160.66

Typical copayment $28.72 (range $5.30 – $40.16)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DELIA CUMBA PHD

Psychologist (Clinical Child & Adolescent)