Active NPI
Matthew Noah Fastman
- Clinical Psychologist
- Great Neck, NY
National Provider Identifier
1144807702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- P132187
- Practice address
- 60 Cuttermill Rd Ste 404
Great Neck, NY 11021-3104 - Phone
- (914) 527-0339
- NPI assigned
- Mar 28, 2021
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | P132187 | NY | Primary |
Addresses
Primary practice location
60 Cuttermill Rd Ste 404
Great Neck, NY 11021-3104
Mailing address
60 Cuttermill Rd Ste 404
Great Neck, NY 11021-3104
Phone (914) 527-0339
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 23, 2026 through Apr 23, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P132187 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748217600000",
"number": "1144807702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 CUTTERMILL RD STE 404",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110213104",
"telephone_number": "914-527-0339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 CUTTERMILL RD STE 404",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110213104",
"telephone_number": "914-527-0339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FASTMAN",
"first_name": "MATTHEW",
"middle_name": "NOAH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-28",
"last_updated": "2025-05-26",
"certification_date": "2025-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "P132187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2025; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.