Individual provider Active NPI

Daniel L Hoffman

  • Clinical Psychologist
  • Fresh Meadows, NY
National Provider Identifier
1902037369
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
18861 Issued in NY
Practice address
6143 186TH St
Fresh Meadows, NY 11365-2710
Phone
(516) 874-6854
NPI assigned
Aug 3, 2009
Last updated
Jun 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X
Clinical Psychologist 103TC0700X 18861 NY Primary
Clinical Child & Adolescent Psychologist 103TC2200X 18861 NY

Addresses

Primary practice location

6143 186TH St
Fresh Meadows, NY 11365-2710

Mailing address

14411 69TH Ave
Flushing, NY 11367-1709
Phone (516) 874-6854

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
I20150423002075 NY Practitioner - Clinical Psychologist 8628233871 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18861NYMDClinical Child & Adolescent Psychologist
018861NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC Clinical CurrentSince Mar 2, 2015 Accepting new patients
North Shore-Lij Medical PC CurrentSince Oct 16, 2020 Accepting new patients
North Shore - Lij Medical PC CurrentSince Oct 16, 2020 Accepting new patients

Locations

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: danielhoffman@nslijmedgr.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1902037369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14411 69TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671709",
            "telephone_number": "516-874-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6143 186TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652710",
            "telephone_number": "516-874-6854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "DANIEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-03",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "18861",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "18861",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

Verify at the official NPI Registry.