Wilfred Van Gorp, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

12676 Issued in NY

Practice address

240 Central Park S Apt 2B
New York, NY 10019-1429

Phone

(212) 247-1350

NPI assigned

Mar 13, 2007

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Sep 1, 2016 through Sep 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1356474092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 CENTRAL PARK S APT 2B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191429",
            "telephone_number": "212-247-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 CENTRAL PARK S APT 2B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191429",
            "telephone_number": "212-247-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN GORP",
        "first_name": "WILFRED",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071007843",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "12676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Elizabeth Van Dyk, MD
• Leontine Julie Van Elden, MD, PHD
• Mara Kramer Van Etten, MS, CGC
• Christie Van Florcke, PA
• Max Van Gilder, MD
• Cheryl Lynn Van Hare, PA
• Julie Van Hassel, MD
• Olivier Van Hauwermeiren, PSY. D.
• Elizabeth Van Hell, NURSE PRACTITIONER
• Jennifer Lynne Van Helmond, MD

• Clinical Neuropsychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Neuropsychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.