Organization Active NPI

Stuart G. Gold, Psy.D., PH.D., LLC

  • Clinical Psychologist
  • Coral Gables, FL
National Provider Identifier
1245472422
Registry record updated Aug 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY6015 Issued in FL
Legal business name
STUART G. GOLD, PSY.D., PH.D., LLC
Practice address
1450 Madruga Ave Ste 300
Coral Gables, FL 33146-3164
Phone
(305) 793-4159
NPI assigned
Apr 2, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2013

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

Authorized official

Name
Elizabeth M Thomas, PSY.D., PH.D.NPI 1942214721
Title
Managing Member
Phone
(305) 793-4159

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 PY6015 FL Primary

Addresses

Primary practice location

1450 Madruga Ave Ste 300
Coral Gables, FL 33146-3164

Mailing address

3240 SW 192ND Ave
Miramar, FL 33029-5821
Phone (305) 793-4159

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131218000667 FL Part B Supplier - Clinic/Group Practice 9638306665 Receives reassigned benefits from 1 practitioner
Practice locations: Coral Gables, FL

National Provider Directory

National Provider Directory

Locations

1450 Madruga Ave
Ste 300
Coral Gables, FL 33146
Phone (305) 495-3588

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 2

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": "1238630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375488000000",
    "number": "1245472422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 SW 192ND AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330295821",
            "telephone_number": "305-793-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 MADRUGA AVE STE 300",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331463164",
            "telephone_number": "305-793-4159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STUART G. GOLD, PSY.D., PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-02",
        "last_updated": "2013-08-03",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "305-793-4159",
        "authorized_official_credential": "PSY.D., PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY6015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2013; 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.