Individual provider Active NPI

Monica Caroline Blum, PH.D.

  • Psychologist
  • Highland Park, NJ
National Provider Identifier
1104907831
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
SI 03530 Issued in NJ
Practice address
47 Raritan Ave
Suite #120
Highland Park, NJ 08904-2440
Phone
(732) 296-8046
Fax
(732) 296-8046
NPI assigned
Oct 18, 2006
Sex
Female
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 SI 03530 NJ Primary

Addresses

Primary practice location

47 Raritan Ave
Suite #120
Highland Park, NJ 08904-2440

Mailing address

47 Raritan Ave
Suite #120
Highland Park, NJ 08904-2440
Phone (732) 296-8046

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
I20051019000546 NJ Practitioner - Clinical Psychologist 4688699580 Practice locations: Highland Park, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

47 Raritan Ave
Suite 120
Highland Park, NJ 08904-2440
Phone (732) 296-8046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
SI 03530NJMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104907831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 RARITAN AVE",
            "address_2": "SUITE #120",
            "city": "HIGHLAND PARK",
            "state": "NJ",
            "postal_code": "089042440",
            "telephone_number": "732-296-8046",
            "fax_number": "732-296-8046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 RARITAN AVE",
            "address_2": "SUITE #120",
            "city": "HIGHLAND PARK",
            "state": "NJ",
            "postal_code": "089042440",
            "telephone_number": "732-296-8046",
            "fax_number": "732-296-8046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUM",
        "first_name": "MONICA",
        "middle_name": "CAROLINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "SI 03530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, NJ

Sources for this page

Verify at the official NPI Registry.