Active NPI
Nancy Beth Goldov, PSYD, BC-DMT
- Clinical Psychologist
- Seattle, WA
National Provider Identifier
1396013132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY-60246450
- Practice address
- 1314 NE 43Rd St Ste 209
Seattle, WA 98105-5832 - Phone
- (206) 979-9743
- NPI assigned
- Dec 8, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY-60246450 | WA | Primary |
Addresses
Primary practice location
1314 NE 43Rd St Ste 209
Seattle, WA 98105-5832
Mailing address
5802 17TH Ave NE
Seattle, WA 98105-2512
Phone (206) 979-9743
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130205000579 | WA | Practitioner - Psychologist Billing Independently | 7719131432 | Practice locations: Seattle, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1314 NE 43Rd St
Seattle, WA 98105-5832
Phone (206) 979-9743
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY-60246450 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485820800000",
"number": "1396013132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5802 17TH AVE NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981052512",
"telephone_number": "206-979-9743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1314 NE 43RD ST STE 209",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981055832",
"telephone_number": "206-979-9743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDOV",
"first_name": "NANCY",
"middle_name": "BETH",
"name_prefix": "Dr.",
"credential": "PSYD, BC-DMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-08",
"last_updated": "2017-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY-60246450",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.