Individual provider Active NPI

Robert L. Kayne, PSY.D.

  • Psychologist
  • Bayside, NY
National Provider Identifier
1720052095
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
010202 Issued in NY
Practice address
22055 46TH Ave
5-V
Bayside, NY 11361-3601
Phone
(917) 971-2166
Fax
(718) 229-4030
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 010202 NY Primary

Addresses

Primary practice location

22055 46TH Ave
5-V
Bayside, NY 11361-3601

Mailing address

22055 46TH Ave
5-V
Bayside, NY 11361-3601
Phone (917) 971-2166

Other identifiers 1

IdentifierTypeStateIssuer
02728994MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1720052095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22055 46TH AVE",
            "address_2": "5-V",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613601",
            "telephone_number": "917-971-2166",
            "fax_number": "718-229-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22055 46TH AVE",
            "address_2": "5-V",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613601",
            "telephone_number": "917-971-2166",
            "fax_number": "718-229-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYNE",
        "first_name": "ROBERT",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "010202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02728994",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.