Organization Active NPI

Daniel B Goldman PHD, LLC

  • Clinical Psychologist
  • Sarasota, FL
National Provider Identifier
1073877643
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY8470 Issued in FL
Legal business name
DANIEL B GOLDMAN PHD, LLC
Practice address
3205 Southgate Cir
Sarasota, FL 34239-5514
Phone
(941) 444-5578
Fax
(941) 444-5592
NPI assigned
Jun 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Authorized official

Name
Daniel B Goldman, PH.D.NPI 1154699189
Title
Licensed Psychologist
Phone
(941) 444-5578

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY8470 FL Primary

Addresses

Primary practice location

3205 Southgate Cir
Sarasota, FL 34239-5514

Mailing address

3205 Southgate Cir
Sarasota, FL 34239-5514
Phone (941) 444-5578

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130611000381 FL Part B Supplier - Clinic/Group Practice 5597904177 Receives reassigned benefits from 1 practitioner
Practice locations: Sarasota, FL

National Provider Directory

National Provider Directory

Locations

3205 Southgate Cir
#16
Sarasota, FL 34239
Phone (941) 444-5578

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1340841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688601600000",
    "number": "1073877643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 SOUTHGATE CIR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342395514",
            "telephone_number": "941-444-5578",
            "fax_number": "941-444-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 SOUTHGATE CIR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342395514",
            "telephone_number": "941-444-5578",
            "fax_number": "941-444-5592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL B GOLDMAN PHD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-28",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "941-444-5578",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8470",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.