Individual provider Active NPI

Stuart Pinkwater, PSYD

  • Psychologist
  • Highland Park, IL
National Provider Identifier
1942389325
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
071004679 Issued in IL
Practice address
1866 Sheridan Rd
Suite 216
Highland Park, IL 60035-2547
Phone
(847) 433-0800
Fax
(847) 432-3862
NPI assigned
Nov 4, 2006
Last updated
Sep 23, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071004679 IL Primary

Addresses

Primary practice location

1866 Sheridan Rd
Suite 216
Highland Park, IL 60035-2547

Mailing address

1866 Sheridan Rd Ste 305
Highland Park, IL 60035-2546
Phone (847) 951-3951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20041215000424 IL Practitioner - Clinical Psychologist 1759348337 Reassigns benefits to 1 organization
Practice locations: Highland Park, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1415 Bordeaux CT
Highland Park, IL 60035-3903
Phone (847) 951-3951

2070 Green Bay Rd
Suite 179
Highland Park, IL 60035-2412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Davken Associates, P.C. CurrentSince Jan 26, 2018 Accepting new patients

Locations

1426 W Birchwood Ave
Chicago, IL 60626
Phone (773) 274-4405

Organizations & group practices 2

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": "1162598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1942389325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1866 SHERIDAN RD STE 305",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352546",
            "telephone_number": "847-951-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1866 SHERIDAN RD",
            "address_2": "SUITE 216",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352547",
            "telephone_number": "847-433-0800",
            "fax_number": "847-432-3862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINKWATER",
        "first_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-04",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071004679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

Verify at the official NPI Registry.