Individual provider Active NPI

Gregory Goffinet, PSYD

  • Clinical Neuropsychologist
  • Vincennes, IN
National Provider Identifier
1821329392
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
20042397A Issued in IN
Practice address
520 S 7TH St
Vincennes, IN 47591-1038
Phone
(812) 882-5220
NPI assigned
Jan 23, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20042397A IN
Clinical Neuropsychologist 103G00000X 20042397A IN Primary

Addresses

Primary practice location

520 S 7TH St
Vincennes, IN 47591-1038

Mailing address

801 Saint Marys Dr
Suite 506 E
Evansville, IN 47714-0511
Phone (812) 402-5625

Other practice location 1

801 Saint Marys Dr
Suite 506E
Evansville, IN 47714-0511
Phone (812) 402-5625

Other identifiers 1

IdentifierTypeStateIssuer
200987220MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100320000246 IN Practitioner - Clinical Psychologist 1658406285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

101 N Plaza E Blvd
Suite 105
Evansville, IN 47715-2804
Phone (812) 402-5625

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20042397AINMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Neuropsychological Consultant Clinical Neuropsychologist CurrentSince Mar 18, 2014 Accepting new patients

Locations

101 N Plaza East Blvd
Ste 105
Evansville, IN 47715
Phone (812) 402-5625

801 Saint Marys Dr
Ste 506E
Evansville, IN 47714
Phone (812) 402-5625

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1264204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1821329392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 SAINT MARYS DR",
            "address_2": "SUITE 506 E",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140511",
            "telephone_number": "812-402-5625",
            "fax_number": "812-402-5627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S 7TH ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911038",
            "telephone_number": "812-882-5220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Saint Marys Dr",
            "address_2": "SUITE 506E",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477140511",
            "country_code": "US",
            "telephone_number": "812-402-5625",
            "fax_number": "812-402-5627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOFFINET",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-23",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042397A",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IN",
            "license": "20042397A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200987220",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

Verify at the official NPI Registry.