Active NPI
Stanley Curt Goldklang, PH.D.
- Psychologist
- Roslyn Heights, NY
National Provider Identifier
1033104146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 007276-1
- Practice address
- 60 Glenwood LN
Roslyn Heights, NY 11577-1411 - Phone
- (516) 621-1025
- Fax
- (516) 621-3064
- NPI assigned
- Sep 14, 2005
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 007276-1 | NY | Primary |
Addresses
Primary practice location
60 Glenwood LN
Roslyn Heights, NY 11577-1411
Mailing address
60 Glenwood LN
Roslyn Heights, NY 11577-1411
Phone (516) 621-1025
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0073403 | Other | GHI PROVIDER NUMBER | |
| 077594 | Other | NY | VALUE OPTIONS |
| 236510 | Other | MHN PROVIDER NUMBER | |
| V26521 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040330001372 | NY | Practitioner - Clinical Psychologist | 3779575980 | Practice locations: Roslyn Heights, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- New York University School of Medicine, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
60 Glenwood LN
Roslyn Heights, NY 11577-1411
Phone (516) 621-1025
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007276-1 | NY | MD | Psychologist |
| 007276 | NY | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1033104146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 GLENWOOD LN",
"city": "ROSLYN HEIGHTS",
"state": "NY",
"postal_code": "115771411",
"telephone_number": "516-621-1025",
"fax_number": "516-621-3064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 GLENWOOD LN",
"city": "ROSLYN HEIGHTS",
"state": "NY",
"postal_code": "115771411",
"telephone_number": "516-621-1025",
"fax_number": "516-621-3064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDKLANG",
"first_name": "STANLEY",
"middle_name": "CURT",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-14",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "007276-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI PROVIDER NUMBER",
"identifier": "0073403",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "077594",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN PROVIDER NUMBER",
"identifier": "236510",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "V26521",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Roslyn Heights, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.