Active NPI
Dodi Goldman, PH.D.
- Clinical Psychologist
- New York, NY
National Provider Identifier
1619008471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 012234-1
- Practice address
- 235 W End Ave
2E
New York, NY 10023-3631 - Phone
- (212) 787-0842
- NPI assigned
- Mar 7, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 | 012234-1 | NY | Primary |
Addresses
Primary practice location
235 W End Ave
2E
New York, NY 10023-3631
Mailing address
37 Nassau Dr
Great Neck, NY 11021-2163
Phone (516) 487-6377
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 12, 2021 through Jul 12, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012234 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619008471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37 NASSAU DR",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110212163",
"telephone_number": "516-487-6377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 W END AVE",
"address_2": "2E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100233631",
"telephone_number": "212-787-0842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMAN",
"first_name": "DODI",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "012234-1",
"primary": true
}
],
"identifiers": [],
"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 Jul 8, 2007; 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.