Individual provider Active NPI

Gokul T Krishnan

  • Speech-Language Pathologist
  • New Hyde Park, NY
National Provider Identifier
1003036088
Registry record updated Jul 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
011539 Issued in NY
Practice address
1035 N 6TH St
New Hyde Park, NY 11040-3030
Phone
(513) 413-8626
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 011539 NY Primary

Addresses

Primary practice location

1035 N 6TH St
New Hyde Park, NY 11040-3030

Mailing address

1035 N 6TH St
New Hyde Park, NY 11040-3030
Phone (513) 413-8626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100724000186 NY Practitioner - Qualified Speech Language Pathologist 2264564392 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1992
Medicare assignment
May accept Medicare assignment
Group practices
Nysarc Inc. Nyc ChapterGroup PAC ID 7214030634, 20 clinicians

Practice addresses (Care Compare)

7649 Hewlett St
New Hyde Park, NY 11040-1429
Phone (212) 388-0767

83 Maiden LN
FL 7
New York, NY 10038-5196
Phone (212) 780-2564

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011539NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
MHH Psychology and Speech-Language Pathology Therapy Services PLLC CurrentSince Nov 3, 2017 Accepting new patients
Nysarc Inc CurrentSince Jun 1, 2007 Accepting new patients
State of New York Comptrollers Office CurrentSince Jun 1, 2019 Accepting new patients
State of New York Comptrollers Office CurrentSince Jun 1, 2019 Accepting new patients
Welllife Network Inc. Past Accepting new patients

Locations

44 Holland Ave
Fl 4
Albany, NY 12208

83 Maiden Ln
New York, NY 10038
Phone (212) 780-2578

83 Maiden Ln
Fl 7
New York, NY 10038
Phone (212) 780-2564

8045 Winchester Blvd
Bldg 80
Queens Village, NY 11427
Phone (718) 217-4242

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1003036088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 N 6TH ST",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110403030",
            "telephone_number": "513-413-8626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 N 6TH ST",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110403030",
            "telephone_number": "513-413-8626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISHNAN",
        "first_name": "GOKUL",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "011539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.