NPIMap

Organization Active NPI

Psychological Assessment and Screening Services PC

  • Psychologist
  • Hicksville, NY
National Provider Identifier
1669928677
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
010194 Issued in NY
Legal business name
PSYCHOLOGICAL ASSESSMENT AND SCREENING SERVICES PC
Practice address
400 S Oyster Bay Rd
Suite 204
Hicksville, NY 11801-3500
Phone
(516) 818-8383
Fax
(516) 605-1181
NPI assigned
Aug 30, 2016
Last updated
Aug 30, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Authorized official

Name
Dr. Fred Holtz, PHDNPI 1629175039
Title
Executive Director
Phone
(516) 818-8383

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 010194 NY Primary

Addresses

Primary practice location

400 S Oyster Bay Rd
Suite 204
Hicksville, NY 11801-3500

Mailing address

400 S Oyster Bay Rd
Suite 204
Hicksville, NY 11801-3500
Phone (516) 818-8383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241107000716 NY Part B Supplier - Clinic/Group Practice 6901330471 Receives reassigned benefits from 1 practitioner
Practice locations: Plainview, NY

National Provider Directory

National Provider Directory

Locations

400 S Oyster Bay Rd
Ste 204
Hicksville, NY 11801
Phone (516) 818-8383

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

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472515200000",
    "number": "1669928677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S OYSTER BAY RD",
            "address_2": "SUITE 204",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013500",
            "telephone_number": "516-818-8383",
            "fax_number": "516-605-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S OYSTER BAY RD",
            "address_2": "SUITE 204",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013500",
            "telephone_number": "516-818-8383",
            "fax_number": "516-605-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL ASSESSMENT AND SCREENING SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-30",
        "last_updated": "2016-08-30",
        "status": "A",
        "authorized_official_last_name": "HOLTZ",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "516-818-8383",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NY",
            "license": "010194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.