Nicole Claire Peniston, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35SI00590000 Issued in NJ

Practice address

3575 Quakerbridge Rd
Hamilton, NJ 08619-1271

Phone

(888) 244-5373

NPI assigned

Feb 22, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shore Psychological Healthcare LLCGroup PAC ID 6305846379, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Shore Psychological Healthcare LLC

  • Clinical Psychologist
  • Brick, NJ
  • NPI 1477563534

  Clinical, NJ

  Medicare reassignment Care Compare group NPD
• Bancroft, a New Jersey Nonprofit Corporation

  • Rehabilitation Clinic/Center
  • Cherry Hill, NJ
  • NPI 1720121106

  NJ

  Medicare reassignment NPD
• Thrive Counseling LLC

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  NJ

  Medicare reassignment NPD
• Lifebulb LLC

  • Mental Health Counselor
  • Toms River, NJ
  • NPI 1699491464
  NPD (past)

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519257600000",
    "number": "1154822443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 HUNTERS GLEN DR",
            "city": "PLAINSBORO",
            "state": "NJ",
            "postal_code": "085363864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 QUAKERBRIDGE RD",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086191271",
            "telephone_number": "888-244-5373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENISTON",
        "first_name": "NICOLE",
        "middle_name": "CLAIRE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-22",
        "last_updated": "2018-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00590000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pedsgastro Center LLC
• Rachel Lynn Pedulla, FNP-BC
• Sabrina Peguero Eduardo
• Patricia Pelc, OTR
• Kerri P Penders, DNP
• Pennington Infectious Disease Associates Inc
• Yesenia Perez
• Performance Spine & Sports Medicine
• Performance Spine & Sports Medicine
• Brian Christopher Perkowski, PT, MPT

• Clinical Psychologist in Hamilton, NJ
• Providers in Hamilton, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.