Active NPI
Robert S Kassoff, PH.D.
- Clinical Psychologist
- Bellmore, NY
National Provider Identifier
1962576389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 8342
- Practice address
- 2053 Bellmore Ave
Bellmore, NY 11710-5603 - Phone
- (516) 481-6200
- Fax
- (516) 481-6200
- NPI assigned
- Nov 17, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 8342 | NY | Primary |
Addresses
Primary practice location
2053 Bellmore Ave
Bellmore, NY 11710-5603
Mailing address
2053 Bellmore Ave
Bellmore, NY 11710-5603
Phone (516) 481-6200
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| V62621 | Other | NY | BLUE CROSS |
| 0028154 | Other | NY | GHI |
| 144362 | Other | NY | VALUE OPTIONS |
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 |
|---|---|---|---|---|
| I20120130000127 | NY | Practitioner - Clinical Psychologist | 8325205651 | Practice locations: Bellmore, NY; Little Neck, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2053 Bellmore Ave
Bellmore, NY 11710-5603
Phone (516) 481-6200
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8342 | NY | MD | Clinical Psychologist |
| 008342 | NY | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391644800000",
"number": "1962576389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2053 BELLMORE AVE",
"city": "BELLMORE",
"state": "NY",
"postal_code": "117105603",
"telephone_number": "516-481-6200",
"fax_number": "516-481-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2053 BELLMORE AVE",
"city": "BELLMORE",
"state": "NY",
"postal_code": "117105603",
"telephone_number": "516-481-6200",
"fax_number": "516-481-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASSOFF",
"first_name": "ROBERT",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-17",
"last_updated": "2014-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "8342",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "V62621",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "0028154",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "144362",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellmore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; 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.