Active NPI
Kevin McGovern
- Psychologist
- Astoria, NY
National Provider Identifier
1245368117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1277625923
- Practice address
- 2534 Steinway St
Astoria, NY 11103-3702 - Phone
- (718) 777-5243
- Fax
- (718) 777-5250
- NPI assigned
- Mar 1, 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 | 1277625923 | NY | Primary |
Addresses
Primary practice location
2534 Steinway St
Astoria, NY 11103-3702
Mailing address
291 Radio Ave
Miller Place, NY 11764-3528
Phone (631) 278-9160
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1277625923 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245368117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "291 RADIO AVE",
"city": "MILLER PLACE",
"state": "NY",
"postal_code": "117643528",
"telephone_number": "631-278-9160",
"fax_number": "718-777-5250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2534 STEINWAY ST",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111033702",
"telephone_number": "718-777-5243",
"fax_number": "718-777-5250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGOVERN",
"first_name": "KEVIN",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "1277625923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Astoria, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.