Organization Active NPI

Dr Rachel Kleinman PSYD PLLC

  • Clinical Psychologist
  • Great Neck, NY
National Provider Identifier
1972029932
Registry record updated Aug 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
019510 Issued in NY
Legal business name
DR RACHEL KLEINMAN PSYD PLLC
Practice address
1 Barstow Rd Ste P24
Great Neck, NY 11021-3501
Phone
(917) 543-5750
NPI assigned
Aug 21, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2017

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

Authorized official

Name
Dr. Rachel KleinmanNPI 1558635615
Title
Licensed Clinical Psychologist
Phone
(917) 543-5750

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 019510 NY Primary

Addresses

Primary practice location

1 Barstow Rd Ste P24
Great Neck, NY 11021-3501

Mailing address

8509 Radnor St
Jamaica, NY 11432-2325
Phone (917) 543-5750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170830002283 NY Part B Supplier - Clinic/Group Practice 3072886829 Receives reassigned benefits from 1 practitioner
Practice locations: Great Neck, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503878400000",
    "number": "1972029932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8509 RADNOR ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114322325",
            "telephone_number": "917-543-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARSTOW RD STE P24",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213501",
            "telephone_number": "917-543-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR RACHEL KLEINMAN PSYD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-21",
        "last_updated": "2017-08-28",
        "status": "A",
        "authorized_official_last_name": "KLEINMAN",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "917-543-5750",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.