Charles Buchbauer, PH.D
Individual provider Active NPI Psychologist · Haskell, NJ
NPI 1164597886 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1164597886
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 35S100419300 (NJ)
- Practice address
- 1433 Ringwood Ave
Haskell, NJ 07420-1520 - Phone
- (973) 839-2119
- Fax
- (973) 616-4193
- NPI assigned
- Nov 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
350 Sparta Ave
Sparta, NJ 07871-1120
Phone (973) 729-0272
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050727000683 | NJ | Practitioner - Clinical Psychologist | 7719915198 | Practice locations: Sparta, NJ |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35S100419300 | NJ | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vericare Behavioral Health of New Jersey, P.a. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 35S100419300 | NJ | Yes |
Addresses
Primary practice location
1433 Ringwood Ave
Haskell, NJ 07420-1520
Mailing address
21 Prospect Ave
Andover, NJ 07821-4514
Phone (973) 729-0272
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0073148 | Medicaid | NJ |
Other providers in Haskell, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.