Individual provider Active NPI

Rosemarie Vala Stewart, PH.D.

  • Psychologist
  • Oradell, NJ
National Provider Identifier
1164766911
Registry record updated Nov 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4896 Issued in NJ
Practice address
680 Kinderkamack Rd
Suite 205
Oradell, NJ 07649-1600
Phone
(917) 647-8053
NPI assigned
Nov 17, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4896 NJ Primary
Psychologist 103T00000X 018643 NY

Addresses

Primary practice location

680 Kinderkamack Rd
Suite 205
Oradell, NJ 07649-1600

Mailing address

297 Kinderkamack Rd Ste 101
Suite 169
Oradell, NJ 07649-1535
Phone (917) 647-8053

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
I20130218000192 NJ Practitioner - Clinical Psychologist 8224282496 Practice locations: Oradell, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

680 Kinderkamack Rd
Suite 205
Oradell, NJ 07649-1600
Phone (917) 647-8053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4896NJMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1353110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353110400000",
    "number": "1164766911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 KINDERKAMACK RD STE 101",
            "address_2": "SUITE 169",
            "city": "ORADELL",
            "state": "NJ",
            "postal_code": "076491535",
            "telephone_number": "917-647-8053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 KINDERKAMACK RD",
            "address_2": "SUITE 205",
            "city": "ORADELL",
            "state": "NJ",
            "postal_code": "076491600",
            "telephone_number": "917-647-8053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "ROSEMARIE",
        "middle_name": "VALA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-17",
        "last_updated": "2012-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "4896",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "018643",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oradell, NJ

Sources for this page

Verify at the official NPI Registry.