Individual provider Active NPI

Fred L Holtz, PH.D.

  • Psychologist
  • Plainview, NY
National Provider Identifier
1629175039
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
010194-1 Issued in NY
Practice address
535 S Oyster Bay Rd
Plainview, NY 11803-3310
Phone
(516) 888-4357
Fax
(516) 513-1456
NPI assigned
Sep 20, 2006
Last updated
Sep 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 010194-1 NY Primary

Addresses

Primary practice location

535 S Oyster Bay Rd
Plainview, NY 11803-3310

Mailing address

535 S Oyster Bay Rd
Plainview, NY 11803-3310
Phone (516) 888-4357

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
I20040708001172 NY Practitioner - Clinical Psychologist 4880672666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

535 S Oyster Bay Rd
Plainview, NY 11803-3310
Phone (516) 888-4357

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010194-1NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fred Holtz CurrentSince Aug 4, 2024 Accepting new patients
Psychological Assessment and Screening Services PC Psychologist CurrentSince Oct 30, 2024 Accepting new patients
Senior Life Management, P.L.L.C. Past Accepting new patients
Holtz Psychological Services, PC Psychologist PastSince Apr 15, 2004 Accepting new patients

Locations

535 S Oyster Bay Rd
Plainview, NY 11803
Phone (516) 818-8383

Organizations & group practices 4

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1629175039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 S OYSTER BAY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118033310",
            "telephone_number": "516-888-4357",
            "fax_number": "516-513-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 S OYSTER BAY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118033310",
            "telephone_number": "516-888-4357",
            "fax_number": "516-513-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTZ",
        "first_name": "FRED",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "010194-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

Verify at the official NPI Registry.