Individual provider Active NPI

Patrice Dow-Nelson, PH.D.

  • Clinical Psychologist
  • Iselin, NJ
National Provider Identifier
1174943971
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5280 Issued in NJ
Practice address
100 Elizabeth Ave
Iselin, NJ 08830-2144
Phone
(908) 420-3932
NPI assigned
Apr 18, 2014
Last updated
Sep 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 5280 NJ Primary

Addresses

Primary practice location

100 Elizabeth Ave
Iselin, NJ 08830-2144

Mailing address

100 Elizabeth Ave
Iselin, NJ 08830-2144
Phone (908) 420-3932

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
I20200429002542 NJ Practitioner - Clinical Psychologist 1456781756 Practice locations: Iselin, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Elizabeth Ave
Iselin, NJ 08830-2144
Phone (908) 420-3932

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5280NJMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1174943971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ELIZABETH AVE",
            "city": "ISELIN",
            "state": "NJ",
            "postal_code": "088302144",
            "telephone_number": "908-420-3932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ELIZABETH AVE",
            "city": "ISELIN",
            "state": "NJ",
            "postal_code": "088302144",
            "telephone_number": "908-420-3932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOW-NELSON",
        "first_name": "PATRICE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "5280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iselin, NJ

Sources for this page

Verify at the official NPI Registry.