Active NPI
Gayle Goodman, PSYD
- Psychologist
- Honolulu, HI
National Provider Identifier
1760532824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 602
- Practice address
- 1802 A Keeaumoku St
Honolulu, HI 96816 - Phone
- (808) 386-5363
- NPI assigned
- Jan 11, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 602 | HI | Primary |
Addresses
Primary practice location
1802 A Keeaumoku St
Honolulu, HI 96816
Mailing address
1407 Koko Head Ave
Honolulu, HI 96816
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 211557 | Other | HMSA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 602 | HI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Shore Physical Therapy, LLC | Past | Accepting new patients |
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.
-
- Physical Therapist
- Honolulu, HI
- NPI 1619023181
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760532824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1407 KOKO HEAD AVE",
"city": "HONOLULU",
"state": "HI",
"postal_code": "96816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1802 A KEEAUMOKU ST",
"city": "HONOLULU",
"state": "HI",
"postal_code": "96816",
"telephone_number": "808-386-5363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "GAYLE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "HI",
"license": "602",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA",
"identifier": "211557",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.