Active NPI
Sabrina Goodman, PH.D.
- Clinical Psychologist
- New York, NY
National Provider Identifier
1457684698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 019496
- Practice address
- 910 W End Ave
1C
New York, NY 10025-3533 - Phone
- (212) 851-8100
- Fax
- (212) 932-0964
- NPI assigned
- Sep 4, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 019496 | NY | |
| Clinical Psychologist | 103TC0700X | 019496 | NY | Primary |
Addresses
Primary practice location
910 W End Ave
1C
New York, NY 10025-3533
Mailing address
244 E 77TH St
Apt 16
New York, NY 10075-2123
Phone (516) 707-0917
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00245029 | Medicaid | NY |
Medicare participation
Medicare enrollment files- 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
- Opted out of Medicare
- Yes, effective Jul 1, 2015 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinical Psychassociates LLP | Psychologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Psychologist
- New York, NY
- NPI 1124051925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347926400000",
"number": "1457684698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "244 E 77TH ST",
"address_2": "APT 16",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100752123",
"telephone_number": "516-707-0917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "910 W END AVE",
"address_2": "1C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100253533",
"telephone_number": "212-851-8100",
"fax_number": "212-932-0964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "SABRINA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-04",
"last_updated": "2012-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "019496",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "019496",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00245029",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; 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.