Individual provider Active NPI

Stacy Popkin-Zang, PSYD

  • Clinical Child & Adolescent Psychologist
  • Roslyn Heights, NY
National Provider Identifier
1477979524
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
020512 Issued in NY
Practice address
70 Glen Cove Rd
Roslyn Heights, NY 11577-1726
Phone
(631) 626-5186
NPI assigned
Mar 13, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 020512 NY Primary

Addresses

Primary practice location

70 Glen Cove Rd
Roslyn Heights, NY 11577-1726

Mailing address

1279 Dorset PL
North Bellmore, NY 11710-2301
Phone (631) 626-5186

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180426000407 NY Practitioner - Clinical Psychologist 8921362062 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Care Diagnostic and Treatment Center ,Inc CurrentSince Apr 1, 2018 Accepting new patients
Stacy Popkin-Zang, PSYD, PLLC Current Accepting new patients
Lifeline Center for Child Development Past Accepting new patients

Locations

230 Hanse Ave
Freeport, NY 11520
Phone (516) 686-4400

189 Wheatley Rd
Glen Head, NY 11545
Phone (516) 626-1075

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1394668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1477979524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1279 DORSET PL",
            "city": "NORTH BELLMORE",
            "state": "NY",
            "postal_code": "117102301",
            "telephone_number": "631-626-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 GLEN COVE RD",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115771726",
            "telephone_number": "631-626-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPKIN-ZANG",
        "first_name": "STACY",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-13",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "020512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn Heights, NY

Sources for this page

Verify at the official NPI Registry.