Individual provider Active NPI

Sebastian Kaplan, PHD

  • Psychologist
  • Winston Salem, NC
National Provider Identifier
1639245012
Registry record updated Nov 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3260 Issued in NC
Practice address
Medical Center Blvd
Winston-Salem, NC 27157
Phone
(336) 716-2255
NPI assigned
Nov 28, 2006
Last updated
Nov 6, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3260 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston-Salem, NC 27157

Mailing address

PO Box 344
Winston Salem, NC 27102-0344
Phone (336) 716-2255

Other identifiers 3

IdentifierTypeStateIssuer
047EJOtherNCBCBS
6000989MedicaidNC
195473OtherNCMEDCOST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20080222000126 NC Practitioner - Clinical Psychologist 7214011733 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Aug 8, 2006 Accepting new patients

Locations

1901 Mooney St
Winston Salem, NC 27103
Phone (336) 716-8091

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

791 Jonestown Rd
Winston Salem, NC 27103
Phone (336) 716-5993

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, 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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225929600000",
    "number": "1639245012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 344",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271020344",
            "telephone_number": "336-716-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27157",
            "telephone_number": "336-716-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPLAN",
        "first_name": "SEBASTIAN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2008-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "3260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "047EJ",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000989",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "195473",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.