Individual provider Active NPI

David Waxman, PHD

  • Psychologist
  • East Meadow, NY
National Provider Identifier
1932284866
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
010106 Issued in NY
Practice address
2201 Hempstead Turnpike
Nassau University Medical Center
East Meadow, NY 11554
Phone
(516) 572-6511
Fax
(516) 572-3210
NPI assigned
Oct 26, 2006
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
Psychologist 103T00000X 010106 NY Primary

Addresses

Primary practice location

2201 Hempstead Turnpike
Nassau University Medical Center
East Meadow, NY 11554

Mailing address

14 Russel Dr
Mineola, NY 11501-4741

Other identifiers 1

IdentifierTypeStateIssuer
010106OtherNYLICENSE NUMBER

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
I20120224000539 NY Practitioner - Clinical Psychologist 6507024387 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Epic Long IslandGroup PAC ID 7315835907, 43 clinicians

Practice addresses (Care Compare)

1500 Hempstead Tpke
East Meadow, NY 11554-1551
Phone 5167397733420

1500 Hempstead Turnpike
East Meadow, NY 11554-1551

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nassau Health Care Corporation CurrentSince Apr 18, 2010 Accepting new patients
Nassau Health Care Corporation CurrentSince Apr 18, 2010 Accepting new patients
Epilepsy Foundation of L.I. CurrentSince Jan 11, 2012 Accepting new patients
Epic Long Island CurrentSince Jan 11, 2012 Accepting new patients

Locations

2201 Hempstead Tpke
East Meadow, NY 11554
Phone (516) 486-6862

1500 Hempstead Tpke
East Meadow, NY 11554
Phone 51673977331420

2201 Hempstead Tpke
Fl 19
East Meadow, NY 11554
Phone (516) 486-6862

2201 Hempstead Tpke
Rm 2448
East Meadow, NY 11554
Phone (516) 572-1234

Organizations & group practices 4

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932284866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 RUSSEL DR",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 HEMPSTEAD TURNPIKE",
            "address_2": "NASSAU UNIVERSITY MEDICAL CENTER",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "11554",
            "telephone_number": "516-572-6511",
            "fax_number": "516-572-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAXMAN",
        "first_name": "DAVID",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "010106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "010106",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

Verify at the official NPI Registry.