Individual provider Active NPI

Eileen H Rosendahl, PH.D.

  • Adult Development & Aging Psychologist
  • Manhasset, NY
National Provider Identifier
1790899854
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Development & Aging PsychologistTaxonomy code 103TA0700X
License
011615 Issued in NY
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, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
AS972OtherNYOXFORD
V7C833OtherNYEMPIRE BC/BS G. NECK OFF
01459750MedicaidNY
VN1131OtherNYEMPIRE 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.