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GARY MICHAEL GOLDETSKY NPI 1124129382


NPI Information

NPI: 1124129382
Provider Name: GARY MICHAEL GOLDETSKY
Classification: Psychologist - 103TR0400X
Entity Type: Individual

Specialization: Rehabilitation

PECOS Registration: Yes

Address:
515 DELAWARE ST SE
TMD CLINIC
MINNEAPOLIS, MN
ZIP 55455
Phone: (612) 626-6529
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Gary Michael Goldetsky is a rehabilitation psychologist in Minneapolis, MN with 40 years of experience. The provider is a psychologist who specializes in the study and application of psychological principles on behalf of persons who have disability due to injury or illness. Rehabilitation psychologists, often within teams, assess and treat cognitive, emotional, and functional difficulties, and help people to overcome barriers to participation in life activities. Rehabilitation psychologists are involved in practice, research, and advocacy, with the broad goal of fostering independence and opportunity for people with disabilities. Gary Michael Goldetsky NPI is 1124129382. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

515 DELAWARE ST SE
TMD CLINIC
MINNEAPOLIS, MN
ZIP 55455-357
Phone: (612) 626-6529

The NPI 1124129382 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Psychotherapy, 60 minutes (HCPCS:90837)

The enumeration date for this NPI number is 9/26/2006 and was last updated on 8/14/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TR0400XPsychologistRehabilitationLPO 508MINNESOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.