Shahal Rozenblatt, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

016095 Issued in NY

Practice address

50 Karl Ave Ste 104
Smithtown, NY 11787-2744

Phone

(631) 378-0741

Fax

(631) 449-7970

NPI assigned

Aug 10, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Advanced Psychological Assessment, P.C.

  • Clinical Neuropsychologist
  • Smithtown, NY
  • NPI 1750417408
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1205837366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 KARL AVE STE 104",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872744",
            "telephone_number": "631-378-0741",
            "fax_number": "631-449-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 KARL AVE STE 104",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872744",
            "telephone_number": "631-378-0741",
            "fax_number": "631-449-7970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Belle Terre Rd",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117771928",
            "country_code": "US",
            "telephone_number": "631-474-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14 Greenway Ter",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113755254",
            "country_code": "US",
            "telephone_number": "718-261-3508",
            "fax_number": "631-449-7970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROZENBLATT",
        "first_name": "SHAHAL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "016095",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "016095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex Rothfeld, M.D.
• Michele Rotkowitz, LMSW
• Stephanie Rotola, LMSW
• Roxanne G. Carfora DO PC
• Jermel Royal, LMSW
• RS Medical Care PC
• Norman Mitchell Rubin, DDS
• Allison Marie Ruggiero
• William A. Rule, M.S., CASAC
• Peter M Rumore, M.D.

• Psychologist in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.

Verify at the official NPI Registry.