Individual provider Active NPI

Despina Psillides, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Flemington, NJ
National Provider Identifier
1174758668
Registry record updated Aug 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
25MA08767200 Issued in NJ
Practice address
2100 Wescott Dr
Flemington, NJ 08822-4603
Phone
(201) 694-8247
NPI assigned
May 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 247188 NY
Internal Medicine Physician 207R00000X 25MA08767200 NJ
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 25MA08767200 NJ Primary

Addresses

Primary practice location

2100 Wescott Dr
Flemington, NJ 08822-4603

Mailing address

2100 Wescott Dr
Flemington, NJ 08822-4603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110303000088 NJ Practitioner - Internal Medicine 5193907715 Reassigns benefits to 1 organization
I20140814001309 NY Practitioner - Internal MedicinePractitioner - Geriatric Medicine 5193907715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

221 County Rd
Cresskill, NJ 07626-1605
Phone (201) 567-9310

Hospital & facility affiliations

  • Valley Home Care Inc. Home health agency, Paramus, NJ, CCN 317008
  • Amedisys Home Health Home health agency, Hackensack, NJ, CCN 317047
  • Visiting Nurse Association of Englewood, Inc Home health agency, Englewood, NJ, CCN 317022
  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
247188NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC Internal Medicine CurrentSince Jul 1, 2014 Accepting new patients
Rockland Cardiology PC PastSince Sep 1, 2013 Accepting new patients

Locations

221 County Rd
Cresskill, NJ 07626
Phone (201) 567-9310

590 Old Hook Rd
Emerson, NJ 07630
Phone (201) 986-9009

24 Elm St
Harrington Pk, NJ 07640
Phone (201) 784-0123

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

2 Crosfield Ave
Ste 407
West Nyack, NY 10994
Phone (845) 353-5050

Interoperability endpoints

  • Direct secure messaging: dpsillides236704@direct.englewoodhealth.org

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344988800000",
    "number": "1174758668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 WESCOTT DR",
            "city": "FLEMINGTON",
            "state": "NJ",
            "postal_code": "088224603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 WESCOTT DR",
            "city": "FLEMINGTON",
            "state": "NJ",
            "postal_code": "088224603",
            "telephone_number": "201-694-8247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PSILLIDES",
        "first_name": "DESPINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-27",
        "last_updated": "2012-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "247188",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08767200",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "25MA08767200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flemington, NJ

Sources for this page

Verify at the official NPI Registry.