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GARY MICHAEL GOLDETSKY
NPI 1124129382
Psychologist - Rehabilitation in Minneapolis, MN

Active since September 26, 2006PECOS Enrolled
515 DELAWARE ST SE, TMD CLINIC, MINNEAPOLIS, MN 55455(612) 626-6529 Get Directions Write a Review

NPPES record last updated: August 14, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Gary Michael Goldetsky NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GARY MICHAEL GOLDETSKY (NPI 1124129382) is an individual rehabilitation provider in Minneapolis, Minnesota, licensed in Minnesota (LPO 508) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124129382
Entity TypeIndividualMale
Primary Taxonomy103TR0400X
Provider Legal NameGARY MICHAEL GOLDETSKY
Location Address515 DELAWARE ST SE, TMD CLINICMinneapolis, MN 55455-0357
Mailing Address515 Delaware St Se, Tmd ClinicMinneapolis, MN 55455-0357
Phone(612) 626-6529
Sole ProprietorNo
Enumeration DateSeptember 26, 2006
Last NPPES UpdateAugust 14, 2007
✔ NPI 1124129382 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · RehabilitationBehavioral Health & Social Service Providers
Taxonomy Code103TR0400X
License✔ Licensed in MN · LPO 508
Definition
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.
515 DELAWARE ST SE, Minneapolis, MN 55455
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gary Michael Goldetsky is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JENNIFER LYNN BONAMICI DDS
Dentist
515 DELAWARE ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-5000
DR. MICHAEL W. LEHNERT DDS
Dentist (Oral and Maxillofacial Surgery)
515 DELAWARE ST SE, 7TH FLOOR, MMHST
MINNEAPOLIS, MN 55455
Hennepin County (612) 624-7133
DR. BRETT ANDREW VOEGELE D.D.S.
Dentist
515 DELAWARE ST SE, 7TH FLOOR, MOOS TOWER
MINNEAPOLIS, MN 55455
Hennepin County (612) 624-8600
DR. LINDA JIN LIU DDS
Student in an Organized Health Care Education/Training Program
515 DELAWARE ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 624-9900
RAIANA M KLINGELHUTZ
Dentist (General Practice)
515 DELAWARE ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-2008
MARY ELIZABETH IMDIEKE
Dentist (Prosthodontics)
515 DELAWARE ST SE, CLEFT PALATE CLINIC - 6TH FLOOR MOOS TOWER
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-2495
PAIGE ELIZABETH REINERS DDS
Dentist
515 DELAWARE ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-2495
HUI LI
Dentist (Prosthodontics)
515 DELAWARE ST SE
MINNEAPOLIS, MN 55455
Hennepin County (734) 450-6874

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gary Goldetsky's NPI number?

The NPI number for Gary Goldetsky is 1124129382. It was assigned to this individual provider in the NPPES registry on September 26, 2006.

Where is Gary Goldetsky located?

Gary Goldetsky practices at 515 Delaware St SE Tmd Clinic, Minneapolis, MN 55455. The listed phone number is (612) 626-6529.

What is Gary Goldetsky's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Rehabilitation, with taxonomy code 103TR0400X.

Is Gary Goldetsky enrolled in Medicare?

Yes. Gary Goldetsky is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Gary Goldetsky was last updated on August 14, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.