Individual provider Active NPI

Robert M. Cristal, PH.D.

  • Psychologist
  • Roslyn Heights, NY
National Provider Identifier
1285731273
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
005576-1 Issued in NY
Practice address
37 Shelter LN
Roslyn Heights, NY 11577-2524
Phone
(516) 621-3339
Fax
(516) 626-0457
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 005576-1 NY Primary

Addresses

Primary practice location

37 Shelter LN
Roslyn Heights, NY 11577-2524

Mailing address

37 Shelter LN
Roslyn Heights, NY 11577-2524
Phone (516) 621-3339

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120109000000 NY Practitioner - Clinical Psychologist 9032385364 Practice locations: Rosyln Heights US, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

37 Shelter Lane
Rosyln Heights US, NY 11577-2524
Phone (516) 621-3339

37 Shelter LN
Roslyn Heights, NY 11577-2524

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
005576-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285731273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 SHELTER LN",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772524",
            "telephone_number": "516-621-3339",
            "fax_number": "516-626-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 SHELTER LN",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772524",
            "telephone_number": "516-621-3339",
            "fax_number": "516-626-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISTAL",
        "first_name": "ROBERT",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "005576-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn Heights, NY

Sources for this page

Verify at the official NPI Registry.