Active NPI
Robert Dworkin, PH.D.
- Psychologist
- Rochester, NY
National Provider Identifier
1366462038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 006933
- Practice address
- 601 Elmwood Ave
Box 604
Rochester, NY 14642-0001 - Phone
- (585) 275-5982
- Fax
- (585) 756-0169
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 006933 | NY | Primary |
Addresses
Primary practice location
601 Elmwood Ave
Box 604
Rochester, NY 14642-0001
Mailing address
601 Elmwood Ave
Box 604
Rochester, NY 14642-0001
Phone (585) 275-5982
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 361562 | Other | NY | MVP PROVIDER ID |
| G0180921590 | Other | NY | BLUE CHOICE GROUP |
| S06933-6W | Other | NY | WORKER'S COMP |
| 000912159001 | Other | NY | BS WNY/HEALTHNOW |
| 5399016 | Other | NY | GHI |
| 7843175 | Other | NY | AETNA |
| 2222 | Other | NY | BLUE SHIELD GROUP |
| 00040345901 | Other | NY | UNIVERA |
| 01719768 | Medicaid | NY | |
| MDG077 | Other | NY | PREFERRED CARE |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006933 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1366462038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 ELMWOOD AVE",
"address_2": "BOX 604",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146420001",
"telephone_number": "585-275-5982",
"fax_number": "585-756-0169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 ELMWOOD AVE",
"address_2": "BOX 604",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146420001",
"telephone_number": "585-275-5982",
"fax_number": "585-756-0169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DWORKIN",
"first_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "006933",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP PROVIDER ID",
"identifier": "361562",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE GROUP",
"identifier": "G0180921590",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKER'S COMP",
"identifier": "S06933-6W",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BS WNY/HEALTHNOW",
"identifier": "000912159001",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "5399016",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7843175",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD GROUP",
"identifier": "2222",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERA",
"identifier": "00040345901",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01719768",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE",
"identifier": "MDG077",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.