Individual provider Active NPI

Wayne S Stein, PSY.D.

  • Clinical Psychologist
  • Indialantic, FL
National Provider Identifier
1962430892
Registry record updated Apr 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY0004439 Issued in FL
Practice address
408 5TH Ave
Indialantic, FL 32903-4280
Phone
(321) 724-9900
Fax
(321) 724-6609
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 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 PY0004439 FL Primary

Addresses

Primary practice location

408 5TH Ave
Indialantic, FL 32903-4280

Mailing address

408 5TH Ave
Indialantic, FL 32903-4280
Phone (321) 724-9900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20131024000097 FL Practitioner - Clinical Psychologist 6800888009 Practice locations: Satellite Beach, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1413 S Patrick Dr
Satellite Beach, FL 32937-4344
Phone (321) 348-7793

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Indialantic Psychiatry & Counseling Center, Inc. Past Accepting new patients
Viera Psychological Services PA Clinical Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270771200000",
    "number": "1962430892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 5TH AVE",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329034280",
            "telephone_number": "321-724-9900",
            "fax_number": "321-724-6609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 5TH AVE",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329034280",
            "telephone_number": "321-724-9900",
            "fax_number": "321-724-6609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEIN",
        "first_name": "WAYNE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2010-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY0004439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indialantic, FL

Sources for this page

Verify at the official NPI Registry.