Active NPI
Alan S. Weinblatt, PSY.D.
- Clinical Psychologist
- Bayside, NY
National Provider Identifier
1972676393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 012440
- Practice address
- 4234 209TH St.
Bayside, NY 11361-2747 - Phone
- (718) 279-4808
- NPI assigned
- Nov 15, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Clinical Psychologist | 103TC0700X | 012440 | NY | Primary |
Addresses
Primary practice location
4234 209TH St.
Bayside, NY 11361-2747
Mailing address
4234 209TH St.
Bayside, NY 11361-2747
Phone (718) 279-4808
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220107000208 | NY | Practitioner - Clinical Psychologist | 6406247170 | Practice locations: Little Neck, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012440 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754956800000",
"number": "1972676393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4234 209TH ST.",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113612747",
"telephone_number": "718-279-4808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4234 209TH ST.",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113612747",
"telephone_number": "718-279-4808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEINBLATT",
"first_name": "ALAN",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2025-08-12",
"certification_date": "2025-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "012440",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.