Individual provider Active NPI

Thomas William Johnson, ED.D.

  • Psychologist
  • Metuchen, NJ
National Provider Identifier
1063546489
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
03388 Issued in NJ
Practice address
167 Main St
Suite 2B
Metuchen, NJ 08840-2744
Phone
(732) 906-0920
NPI assigned
Mar 15, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 03388 NJ Primary

Addresses

Primary practice location

167 Main St
Suite 2B
Metuchen, NJ 08840-2744

Mailing address

167 Main St
Suite 2B
Metuchen, NJ 08840-2744
Phone (732) 906-0920

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
I20050421000009 NJ Practitioner - Clinical Psychologist 6901844026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

31 Dehart St
Morristown, NJ 07960-8619
Phone (732) 906-0920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03388NJMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas W. Johnson, Ed.D., P.C. Psychologist CurrentSince Sep 16, 2002 Accepting new patients

Locations

31 Dehart St
Morristown, NJ 07960
Phone (732) 906-0920

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063546489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 MAIN ST",
            "address_2": "SUITE 2B",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088402744",
            "telephone_number": "732-906-0920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 MAIN ST",
            "address_2": "SUITE 2B",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088402744",
            "telephone_number": "732-906-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "THOMAS",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "03388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metuchen, NJ

Sources for this page

Verify at the official NPI Registry.