Individual provider Active NPI

Alan Winder, PHD

  • Clinical Psychologist
  • Far Rockaway, NY
National Provider Identifier
1891800355
Registry record updated Aug 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
016131 Issued in NY
Practice address
2938 Bayswater Ave
Far Rockaway, NY 11691-1730
Phone
(917) 751-7254
Fax
(866) 575-1763
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2010

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 016131 NY Primary

Addresses

Primary practice location

2938 Bayswater Ave
Far Rockaway, NY 11691-1730

Mailing address

2407 Mott Ave
Far Rockaway, NY 11691-1709
Phone (917) 751-7254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041216001079 NY Practitioner - Clinical Psychologist 2668439043 Reassigns benefits to 1 organization
I20200514000143 NJ Practitioner - Clinical Psychologist 2668439043

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016131NYMDClinical Psychologist

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1891800355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2407 MOTT AVE",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911709",
            "telephone_number": "917-751-7254",
            "fax_number": "866-575-1763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2938 BAYSWATER AVE",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911730",
            "telephone_number": "917-751-7254",
            "fax_number": "866-575-1763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINDER",
        "first_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

Verify at the official NPI Registry.