NPIMap

Organization Active NPI

Stress Care of New Jersey, LLC

  • Community/Behavioral Health Agency
  • Matawan, NJ
National Provider Identifier
1033433834
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
10174-02-04 Issued in NJ
Legal business name
STRESS CARE OF NEW JERSEY, LLC
Practice address
4122 Route 516
Matawan, NJ 07747-7031
Phone
(732) 679-4500
Fax
(732) 679-4549
NPI assigned
Mar 23, 2010
Last updated
Jul 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Authorized official

Name
Mr. Alex Smuklavskiy, MBA
Title
Executive Director
Phone
(732) 679-4500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 10174-02-04 NJ Primary

Addresses

Primary practice location

4122 Route 516
Matawan, NJ 07747-7031

Mailing address

PO Box 612
Englishtown, NJ 07726-0612
Phone (732) 679-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20100525000470 NJ Part B Supplier - Clinic/Group Practice 5294864575 Receives reassigned benefits from 110 practitioners
Practice locations: Manalapan, NJ; Matawan, NJ; Somerset, NJ; Toms River, NJ
O20110526000630 NJ Part A Provider - Community Mental Health Center 5294864575 Practice locations: Matawan, NJ
O20160308001459 NJ Part A Provider - Community Mental Health Center 5294864575 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Manalapan, NJ

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 112

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 112

NPI Registry JSON

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

{
    "created_epoch": "1269302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1033433834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 612",
            "city": "ENGLISHTOWN",
            "state": "NJ",
            "postal_code": "077260612",
            "telephone_number": "732-679-4500",
            "fax_number": "732-679-4549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4122 ROUTE 516",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077477031",
            "telephone_number": "732-679-4500",
            "fax_number": "732-679-4549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRESS CARE OF NEW JERSEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-23",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "SMUKLAVSKIY",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "732-679-4500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "10174-02-04",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matawan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.