Individual provider Active NPI

Robert Howard Goldstein, PH.D.

  • Clinical Psychologist
  • Rochester, NY
National Provider Identifier
1881681575
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2192 Issued in NY
Practice address
2000 Winton Rd S
BLDG 4, Suite 303
Rochester, NY 14618-3970
Phone
(585) 473-7110
Fax
(585) 473-3741
NPI assigned
Sep 29, 2005
Sex
Male
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 2192 NY Primary

Addresses

Primary practice location

2000 Winton Rd S
BLDG 4, Suite 303
Rochester, NY 14618-3970

Mailing address

29 Horseshoe LN S
Henrietta, NY 14467-9706
Phone (585) 334-4557

Other identifiers 1

IdentifierTypeStateIssuer
00471994MedicaidNY

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
I20050520000407 NY Practitioner - Clinical Psychologist 4284675612 Practice locations: Henrietta, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1958
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Henrietta, NY 14467
Phone (585) 473-7110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2192NYMDClinical Psychologist
002192NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881681575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 HORSESHOE LN S",
            "city": "HENRIETTA",
            "state": "NY",
            "postal_code": "144679706",
            "telephone_number": "585-334-4557",
            "fax_number": "585-473-3741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 WINTON RD S",
            "address_2": "BLDG 4, SUITE 303",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146183970",
            "telephone_number": "585-473-7110",
            "fax_number": "585-473-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "ROBERT",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "2192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00471994",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.