ALEXANDER GANTMAN PSY.D.
NPI 1669609780
Psychologist in Valley Village, CA

Active since June 16, 2009Opted out of Medicare · through Apr 1, 2027
12053 EMELITA ST, #7, VALLEY VILLAGE, CA 91607(323) 547-6760 Get Directions Write a Review

NPPES record last updated: August 1, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Alexander Gantman Psy.d. NPPES

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

ALEXANDER GANTMAN PSY.D. (NPI 1669609780) is an individual psychologist in Valley Village, California and active in the NPI registry since June 2009. He has opted out of Medicare through April 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1669609780
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameALEXANDER GANTMANCredential: PSY.D.
Location Address12053 EMELITA ST, #7Valley Village, CA 91607
Mailing Address12053 Emelita St, #7Valley Village, CA 91607 · (323) 547-6760
Sole ProprietorYes
Enumeration DateJune 16, 2009
Last NPPES UpdateAugust 1, 2011
NPI 1669609780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
12053 EMELITA ST, Valley Village, CA 91607

Other Identifiers 2

Medicare PINEE504ZCA
MedicaidPSY236950CA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Alexander Gantman Psy.d. 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 1, 2017 through April 1, 2027.

Opt-Out Effective DateApril 1, 2017
Opt-Out In Effect ThroughApril 1, 2027Opt-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.

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 Alexander Gantman's NPI number?

The NPI number for Alexander Gantman is 1669609780. It was assigned to this individual provider in the NPPES registry on June 16, 2009.

Where is Alexander Gantman located?

Alexander Gantman practices at 12053 Emelita St #7, Valley Village, CA 91607. The listed phone number is (323) 547-6760.

What is Alexander Gantman's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Alexander Gantman enrolled in Medicare?

No. Alexander Gantman has opted out of Medicare through April 1, 2027. 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 Alexander Gantman was last updated on August 1, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.