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DR. SHELLY ELLEN GOLDKLANK PHD
NPI 1154464030
Psychologist - Clinical in New York, NY

Active since February 14, 2007Opted out of Medicare · through Apr 27, 2028
740 WEST END AVENUE, NEW YORK, NY 10025(212) 666-7004 Get Directions Write a Review

NPPES record last updated: May 8, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Shelly Ellen Goldklank Phd NPPES

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

DR. SHELLY ELLEN GOLDKLANK PHD (NPI 1154464030) is an individual clinical provider in New York, New York, licensed in New York (7275) and active in the NPI registry since February 2007. She has opted out of Medicare through April 27, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1154464030
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. SHELLY ELLEN GOLDKLANKCredential: PHD
Location Address740 WEST END AVENUENew York, NY 10025-6248
Mailing Address740 West End AvenueNew York, NY 10025-6248 · (212) 666-7004
Phone(212) 666-7004
Sole ProprietorNo
Enumeration DateFebruary 14, 2007
Last NPPES UpdateMay 8, 2012
✔ NPI 1154464030 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in NY · 7275
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
740 WEST END AVENUE, New York, NY 10025
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Other Identifiers 1

Medicare ID-Type UnspecifiedVMS811NY

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Shelly Ellen Goldklank Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 27, 2022 through April 27, 2028.

Opt-Out Effective DateApril 27, 2022
Opt-Out In Effect ThroughApril 27, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10025 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$198.19 typical visit price
range $65.69 – $198.19
Typical copayment $49.54 (range $16.42 – $49.54)
Most-billed visit code 99205
Established Patient
$114.88 typical visit price
range $21.20 – $160.66
Typical copayment $28.72 (range $5.30 – $40.16)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

MS. DORIS RITA SOLOMON LCSW
Social Worker (Clinical)
740 WEST END AVENUE, SUITE 101
NEW YORK, NY 10025
New York County (212) 865-3158

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 Shelly Goldklank's NPI number?

The NPI number for Shelly Goldklank is 1154464030. It was assigned to this individual provider in the NPPES registry on February 14, 2007.

Where is Shelly Goldklank located?

Shelly Goldklank practices at 740 West End Avenue, New York, NY 10025. The listed phone number is (212) 666-7004.

What is Shelly Goldklank's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Shelly Goldklank enrolled in Medicare?

No. Shelly Goldklank has opted out of Medicare through April 27, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Shelly Goldklank was last updated on May 8, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.