Individual provider Active NPI

Radha Vasant Gholkar, PH.D.

  • Clinical Psychologist
  • Towson, MD
National Provider Identifier
1346401924
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
05255 Issued in MD
Practice address
6701 N Charles St
Towson, MD 21204-6881
Phone
(443) 850-8769
NPI assigned
Jun 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 05255 MD Primary

Addresses

Primary practice location

6701 N Charles St
Towson, MD 21204-6881

Mailing address

22212 Fulmer Ave
Clarksburg, MD 20871-3468
Phone (443) 850-8769

Other practice location 1

4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone (310) 390-6612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20170803002366 MD Practitioner - Clinical Psychologist 5799056123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
66.41 of 100Reported as group
Quality
30.12
Promoting interoperability
80
Improvement activities
40
Cost
57.93

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sheppard Pratt Physicians, P.a. CurrentSince Jul 24, 2023 Accepting new patients

Locations

6701 N Charles St
Towson, MD 21204
Phone (443) 849-2000

6501 N Charles St
Towson, MD 21204
Phone (410) 938-3000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1346401924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22212 FULMER AVE",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208713468",
            "telephone_number": "443-850-8769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 N CHARLES ST",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212046881",
            "telephone_number": "443-850-8769"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4760 Sepulveda Blvd",
            "address_purpose": "LOCATION",
            "city": "Culver City",
            "state": "CA",
            "postal_code": "902304820",
            "country_code": "US",
            "telephone_number": "310-390-6612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHOLKAR",
        "first_name": "RADHA",
        "middle_name": "VASANT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-17",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.