Individual provider Active NPI

Marlene Noumoff Kasman, PHD

  • Clinical Psychologist
  • East Northport, NY
National Provider Identifier
1831203892
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3404 Issued in NY
Practice address
163 Town Line Rd
East Northport, NY 11731-3916
Phone
(631) 368-5566
Fax
(631) 368-1934
NPI assigned
Aug 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3404 NY Primary

Addresses

Primary practice location

163 Town Line Rd
East Northport, NY 11731-3916

Mailing address

163 Town Line Rd
East Northport, NY 11731-3916
Phone (631) 368-5566

Other identifiers 2

IdentifierTypeStateIssuer
0055961OtherNYGHI
027126OtherNYVALUE OPTIONS, INC

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
I20100521000343 NY Practitioner - Clinical Psychologist 5890824312 Practice locations: East Northport, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

163 Town Line Rd
East Northport, NY 11731-3916
Phone (631) 368-5566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3404NYMDClinical Psychologist
003404NYMDAcupuncturist

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": "1183852800000",
    "number": "1831203892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 TOWN LINE RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117313916",
            "telephone_number": "631-368-5566",
            "fax_number": "631-368-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 TOWN LINE RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117313916",
            "telephone_number": "631-368-5566",
            "fax_number": "631-368-1934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASMAN",
        "first_name": "MARLENE",
        "middle_name": "NOUMOFF",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "3404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0055961",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS, INC",
            "identifier": "027126",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Northport, NY

Sources for this page

Verify at the official NPI Registry.