Individual provider Active NPI

Joan Gollin Gaines, JOAN GAINES, PH.D.

  • Clinical Psychologist
  • Coral Gables, FL
National Provider Identifier
1104906320
Registry record updated Nov 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY0004309 Issued in FL
Practice address
1450 Madruga Ave
310
Coral Gables, FL 33146-3148
Phone
(305) 663-5808
Fax
(305) 663-5809
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY0004309 FL Primary

Addresses

Primary practice location

1450 Madruga Ave
310
Coral Gables, FL 33146-3148

Mailing address

7321 SW 108TH Ter
Miami, FL 33156-3853
Phone (305) 665-1099

Other names 1

  • Dr. Joan G Gaines Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110525000312 FL Practitioner - Clinical Psychologist 8527244656 Practice locations: Pinecrest, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7321 SW 108TH Ter
Pinecrest, FL 33156-3853
Phone (305) 342-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY0004309FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lana M Stern PHD PA Past Accepting new patients

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289779200000",
    "number": "1104906320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7321 SW 108TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331563853",
            "telephone_number": "305-665-1099",
            "fax_number": "305-665-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 MADRUGA AVE",
            "address_2": "310",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331463148",
            "telephone_number": "305-663-5808",
            "fax_number": "305-663-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAINES",
        "first_name": "JOAN",
        "middle_name": "GOLLIN",
        "name_prefix": "Dr.",
        "credential": "JOAN  GAINES, PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2010-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY0004309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOAN",
            "last_name": "GAINES",
            "middle_name": "G",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.