Keith Golin, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35SI0040990 Issued in NJ

Practice address

659 Eagle Rock Ave
Ste 4
West Orange, NJ 07052-2138

Phone

(888) 284-2034

Fax

(973) 992-4639

NPI assigned

Jun 22, 2006

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

Enrolled in NJ

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

Specialty

Clinical Psychologist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Keith Golin PHD LLCGroup PAC ID 6608879226, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Keith Golin PHD LLC

  • Clinical Psychologist
  • West Orange, NJ
  • NPI 1487660213
  Medicare reassignment Care Compare group NPD Authorized official
• Keith Golin PHD LLC

  • Clinical Psychologist
  • Livingston, NJ
  • NPI 1548561053
  NPD Authorized official
• Keith Golin PHD FL LLC

  • Clinical Psychologist
  • St Petersburg, FL
  • NPI 1043057649
  NPD (past) Authorized official
• South Beach Medical PC

  • Internal Medicine Physician
  • Far Rockaway, NY
  • NPI 1699872499

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1689610875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 ASPEN DR",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070391432",
            "telephone_number": "888-284-2034",
            "fax_number": "973-992-4639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "659 EAGLE ROCK AVE",
            "address_2": "STE 4",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522138",
            "telephone_number": "888-284-2034",
            "fax_number": "973-992-4639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLIN",
        "first_name": "KEITH",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI0040990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMARY INSURANCE CO",
            "identifier": "1487660213",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.