Active NPI
Eileen H Rosendahl, PH.D.
- Adult Development & Aging Psychologist
- Manhasset, NY
National Provider Identifier
1790899854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Development & Aging Psychologist
- License
- 011615
- Practice address
- 585 Plandome Rd
Suite 106
Manhasset, NY 11030-1971 - Phone
- (516) 869-8877
- Fax
- (516) 869-8877
- NPI assigned
- Aug 18, 2006
- Last updated
- Dec 10, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Development & Aging Psychologist | 103TA0700X | 011615 | NY | Primary |
| Clinical Psychologist | 103TC0700X | 011615 | NY | |
| Health Service Psychologist | 103TH0100X | 011615 | NY |
Addresses
Primary practice location
585 Plandome Rd
Suite 106
Manhasset, NY 11030-1971
Mailing address
585 Plandome Rd
Suite 106
Manhasset, NY 11030-1971
Phone (516) 869-8877
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AS972 | Other | NY | OXFORD |
| V7C833 | Other | NY | EMPIRE BC/BS G. NECK OFF |
| 01459750 | Medicaid | NY | |
| VN1131 | Other | NY | EMPIRE BC/BS MANHASSET OF |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050305000045 | NY | Practitioner - Clinical Psychologist | 4688628381 | Practice locations: Great Neck, NY; Port Washington, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Northwestern University Feinberg Medical School, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
51 Great Neck Rd
Great Neck, NY 11021-3333
Phone (516) 869-8877
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arthur Rifkin, MD, PLLC | 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.
-
- Adult Mental Health Clinic/Center
- Manhasset, NY
- NPI 1649465519
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449705600000",
"number": "1790899854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "585 PLANDOME RD",
"address_2": "SUITE 106",
"city": "MANHASSET",
"state": "NY",
"postal_code": "110301971",
"telephone_number": "516-869-8877",
"fax_number": "516-869-8877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "585 PLANDOME RD",
"address_2": "SUITE 106",
"city": "MANHASSET",
"state": "NY",
"postal_code": "110301971",
"telephone_number": "516-869-8877",
"fax_number": "516-869-8877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENDAHL",
"first_name": "EILEEN",
"middle_name": "H",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-18",
"last_updated": "2015-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": "NY",
"license": "011615",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "011615",
"primary": false
},
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "NY",
"license": "011615",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "AS972",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC/BS G. NECK OFF",
"identifier": "V7C833",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01459750",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC/BS MANHASSET OF",
"identifier": "VN1131",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Manhasset, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; 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.