Gavin Ryan Shafron, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

024241 Issued in NY

Practice address

276 5TH Ave RM 605
New York, NY 10001-4527

Phone

(813) 389-1788

NPI assigned

Jun 23, 2014

Sex

Male

Sole proprietor

No

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

Opted out of Medicare

Yes, effective Jul 25, 2024 through Jul 25, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1396150900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 5TH AVENUE",
            "address_2": "SUITE 605",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016228",
            "telephone_number": "813-389-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 5TH AVE RM 605",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014527",
            "telephone_number": "813-389-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFRON",
        "first_name": "GAVIN",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "024241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Shafiro, DPT
• Hasti Shafiye-Mogadam, PA-C
• Farshad Shafizadeh, M.D.
• Negin Shafizadeh, M.D.
• Robin Begun Shafran, PH.D
• Roberta Shafter, PHD, LCSW
• Melissa Shafton
• Shaina Shagalow, PHD
• Simon Shagrin, PH.D.
• Pia Shah Pankiewicz

• Psychologist in New York, NY
• Providers in New York, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.