Individual provider Active NPI

Stanley A Cohen, D.O.P.A.

  • Child & Adolescent Psychiatry Physician
  • St Augustine, FL
National Provider Identifier
1457437584
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
OS7389 Issued in FL
Practice address
605 Palencia Club Dr # 201
St Augustine, FL 32095-6901
Phone
(904) 808-8595
Fax
(904) 808-8596
NPI assigned
Oct 31, 2006
Last updated
Sep 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X OS7389 FL
Child & Adolescent Psychiatry Physician 2084P0804X OS7389 FL Primary

Addresses

Primary practice location

605 Palencia Club Dr # 201
St Augustine, FL 32095-6901

Mailing address

605 Palencia Club Dr # 201
St Augustine, FL 32095-6901
Phone (904) 808-8595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081009000619 FL Practitioner - Psychiatry 6305914920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stanley a Cohen DO PAGroup PAC ID 3173691698, 3 clinicians

Practice addresses (Care Compare)

605 Palencia Club Dr
Suite 201
St Augustine, FL 32095-6901
Phone (904) 808-8595

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stanley a Cohen DO PA Psychiatry CurrentSince Jan 2, 2008 Accepting new patients
Psychological Services of St. Augustine Past Accepting new patients

Locations

605 Palencia Club Dr
#201
Saint Augustine, FL 32095
Phone (904) 808-8595

605 Palencia Club Dr
Ste 201
Saint Augustine, FL 32095
Phone (904) 808-8595

354 Paseo Reyes Dr
St Augustine, FL 32095
Phone (904) 755-6592

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1457437584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 PALENCIA CLUB DR # 201",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320956901",
            "telephone_number": "904-808-8595",
            "fax_number": "904-808-8596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 PALENCIA CLUB DR # 201",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320956901",
            "telephone_number": "904-808-8595",
            "fax_number": "904-808-8596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "STANLEY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "OS7389",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "OS7389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.