NPIMap

Organization Active NPI

Abby Road Psychiatric Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Red Bank, NJ
National Provider Identifier
1053807305
Registry record updated Aug 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
ABBY ROAD PSYCHIATRIC SERVICES LLC
Practice address
7 Hendrickson Ave
Red Bank, NJ 07701-6122
Phone
(732) 893-5316
NPI assigned
Jul 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2023

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

Authorized official

Name
Anthony DimuraNPI 1124520333
Title
Owner
Phone
(908) 433-7263

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

7 Hendrickson Ave
Red Bank, NJ 07701-6122

Mailing address

7 Hendrickson Ave
Red Bank, NJ 07701-6122
Phone (732) 893-5316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181203000118 NJ Part B Supplier - Clinic/Group Practice 1658615638 Receives reassigned benefits from 15 practitioners
Practice locations: Red Bank, NJ; Toms River, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2170805Abby Road Psychiatric Services, LLC7 Hendrickson Ave, Red Bank, NJ 07701Certificate of waiverAug 19, 2027

National Provider Directory

National Provider Directory

Locations

7 Hendrickson Ave
Ste 105
Red Bank, NJ 07701

7 Hendrickson Ave
Red Bank, NJ 07701
Phone (732) 893-5314

10 Drs James Parker Blvd
Ste 105
Red Bank, NJ 07701
Phone (908) 433-7263

3 Plaza Dr
Ste 15
Toms River, NJ 08757
Phone (732) 240-5656

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691193600000",
    "number": "1053807305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 HENDRICKSON AVE",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077016122",
            "telephone_number": "732-893-5316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 HENDRICKSON AVE",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077016122",
            "telephone_number": "732-893-5316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABBY ROAD PSYCHIATRIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-10",
        "last_updated": "2023-08-05",
        "certification_date": "2023-08-05",
        "status": "A",
        "authorized_official_last_name": "DIMURA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-433-7263"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.