Alexander Gantman, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

12053 Emelita St
#7
Valley Village, CA 91607

Phone

(323) 547-6760

NPI assigned

Jun 16, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2017 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Advanced Minds a Professional Psychological Corporation

  • Clinical Psychologist
  • Los Angeles, CA
  • NPI 1669395810
  NPD (past) Authorized official

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312156800000",
    "number": "1669609780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12053 EMELITA ST",
            "address_2": "#7",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "91607",
            "telephone_number": "323-547-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12053 EMELITA ST",
            "address_2": "#7",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "91607",
            "telephone_number": "323-547-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANTMAN",
        "first_name": "ALEXANDER",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-16",
        "last_updated": "2011-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY236950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• G Murdock PHD a Psychological Corporation
• Yocheved Sara Gabay
• Tiffany Gabbai, OT
• Marc Gallemore, CMT
• Daniel James Gannon, B.S. R.PH
• Lusya Gasparyan
• Gemini Home Health Inc.
• Alexander Illych Gerbakher, DMD
• Svetlana Germashev, OTR/L
• Yury Geylikman, D.M.D.

• Psychologist in Valley Village, CA
• Providers in Valley Village, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2011; 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.

Verify at the official NPI Registry.