Individual provider Active NPI

Robert Kenneth Winegar, PSY.D.

  • Clinical Neuropsychologist
  • Sarasota, FL
National Provider Identifier
1003967514
Registry record updated Aug 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
6215 Issued in FL
Practice address
1991 Hyde Park St
Sarasota, FL 34239-3600
Phone
(941) 953-4313
Fax
(941) 954-8631
NPI assigned
Jan 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 6215 FL Primary
Clinical Psychologist 103TC0700X 6215 FL

Addresses

Primary practice location

1991 Hyde Park St
Sarasota, FL 34239-3600

Mailing address

1991 Hyde Park St
Sarasota, FL 34239-3600
Phone (941) 953-4313

Other identifiers 4

IdentifierTypeStateIssuer
7006202OtherFLAETNA
768885700MedicaidFL
279833OtherFLSTAYWELL/HEALTHEASE/WELLC
54586OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6215FLMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Neuropsychology and Behavioral Health Assoicates, PA. Clinical Neuropsychologist Current Accepting new patients

Locations

1991 Hyde Park St
Sarasota, FL 34239
Phone (941) 953-4313

Organizations & group practices 1

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": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313712000000",
    "number": "1003967514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 HYDE PARK ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342393600",
            "telephone_number": "941-953-4313",
            "fax_number": "941-954-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 HYDE PARK ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342393600",
            "telephone_number": "941-953-4313",
            "fax_number": "941-954-8631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINEGAR",
        "first_name": "ROBERT",
        "middle_name": "KENNETH",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-13",
        "last_updated": "2011-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "6215",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "6215",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7006202",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "768885700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAYWELL/HEALTHEASE/WELLC",
            "identifier": "279833",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "54586",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.