Active NPI
Stanley M. Goldstein, PH.D.
- Clinical Psychologist
- Middletown, NY
National Provider Identifier
1962496463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 004697-1
- Practice address
- 1050 Route 211 E
Middletown, NY 10941-3726 - Phone
- (845) 692-0614
- Fax
- (815) 642-9611
- NPI assigned
- Sep 12, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 004697-1 | NY | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 004697-1 | NY |
Addresses
Primary practice location
1050 Route 211 E
Middletown, NY 10941-3726
Mailing address
1050 Route 211 East
P.O. Box 4732
Middletown, NY 10941-8732
Phone (845) 692-0614
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041206001150 | NY | Practitioner - Clinical Psychologist | 6305737461 | Practice locations: Middletown, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1973
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1050 Route 211 E
Middletown, NY 10941-3726
Phone (845) 692-0614
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004697-1 | NY | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284854400000",
"number": "1962496463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 ROUTE 211 EAST",
"address_2": "P.O. BOX 4732",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109418732",
"telephone_number": "845-692-0614",
"fax_number": "815-642-9611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 ROUTE 211 E",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109413726",
"telephone_number": "845-692-0614",
"fax_number": "815-642-9611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSTEIN",
"first_name": "STANLEY",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-12",
"last_updated": "2010-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "004697-1",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NY",
"license": "004697-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.