Individual provider Active NPI

Megan A Glenn, PSYD

  • Clinical Neuropsychologist
  • Neptune, NJ
National Provider Identifier
1003457672
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
35SI00758300 Issued in NJ
Practice address
19 Davis Ave
Neptune, NJ 07753-4488
Phone
(732) 897-3700
NPI assigned
Oct 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PS018910 PA
Clinical Neuropsychologist 103G00000X 35SI00758300 NJ Primary

Addresses

Primary practice location

19 Davis Ave
Neptune, NJ 07753-4488

Mailing address

331 Newman Springs Rd
Red Bank, NJ 07701-5688

Other practice location 1

1 Jefferson Barracks Dr
Saint Louis, MO 63125-4181
Phone (314) 652-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241205000603 NJ Practitioner - Clinical Psychologist 7012347768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

19 Davis Ave
Neptune, NJ 07753-4488

1944 Route 33
Neptune, NJ 07753
Phone (732) 776-3787

1945 Route 33
Neptune, NJ 07753

3600 Route 66
FL 3
Neptune, NJ 07753

Hospital & facility affiliations

  • Jersey Shore University Medical Center Hospital, Neptune, NJ, CCN 310073

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35SI00758300NJMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Nov 19, 2024 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Nov 19, 2024 Accepting new patients
Kenneth B Goldberg & Associates Clinical Neuropsychologist PastSince Mar 1, 2020 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

1944 State Route 33
Neptune, NJ 07753
Phone (732) 776-3787

331 Newman Springs Rd
Ste 220
Red Bank, NJ 07701
Phone (732) 807-0514

19 Davis Ave
Wall Township, NJ 07753
Phone (732) 776-4551

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1003457672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS RD",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 DAVIS AVE",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534488",
            "telephone_number": "732-897-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Jefferson Barracks Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631254181",
            "country_code": "US",
            "telephone_number": "314-652-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLENN",
        "first_name": "MEGAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "PA",
            "license": "PS018910",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NJ",
            "license": "35SI00758300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune, NJ

Sources for this page

Verify at the official NPI Registry.