Active NPI
Gerald Stephen Kane, PHD
- Psychologist
- Bellport, NY
National Provider Identifier
1871673715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 0083351
- Practice address
- 112 South Country Road
Suite 116
Bellport, NY 11713 - Phone
- (631) 776-2410
- Fax
- (631) 776-2409
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- 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 | 0083351 | NY | Primary |
Addresses
Primary practice location
112 South Country Road
Suite 116
Bellport, NY 11713
Mailing address
112 South Country Road
Suite 116
Bellport, NY 11713
Phone (631) 776-2410
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00888624 | Medicaid | NY |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0083351 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871673715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 SOUTH COUNTRY ROAD",
"address_2": "SUITE 116",
"city": "BELLPORT",
"state": "NY",
"postal_code": "11713",
"telephone_number": "631-776-2410",
"fax_number": "631-776-2409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 SOUTH COUNTRY ROAD",
"address_2": "SUITE 116",
"city": "BELLPORT",
"state": "NY",
"postal_code": "11713",
"telephone_number": "631-776-2410",
"fax_number": "631-776-2409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANE",
"first_name": "GERALD",
"middle_name": "STEPHEN",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "0083351",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00888624",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellport, NY
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.