Active NPI
Elizabeth E Vergoz, PH D
- Psychologist
- Ridgewood, NJ
National Provider Identifier
1205840600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4253
- Practice address
- 65 N Maple Ave
Suite 301
Ridgewood, NJ 07450-3233 - Phone
- (201) 655-5434
- NPI assigned
- Jul 28, 2006
- Last updated
- Aug 24, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 0117161 | NY | |
| Psychologist | 103T00000X | 4253 | NJ | Primary |
Addresses
Primary practice location
65 N Maple Ave
Suite 301
Ridgewood, NJ 07450-3233
Mailing address
65 N Maple Ave
Suite 301
Ridgewood, NJ 07450-3233
Phone (201) 655-5434
Other names 1
- Elizabeth E Vergoz-Rekis
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061208000108 | NJ | Practitioner - Clinical Psychologist | 5092739417 | Practice locations: Ridgewood, NJ |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
65 N Maple Ave
Suite 301
Ridgewood, NJ 07450-3233
Phone (201) 655-5434
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4253 | NJ | MD | Psychologist |
| 0117161 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629763200000",
"number": "1205840600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 N MAPLE AVE",
"address_2": "SUITE 301",
"city": "RIDGEWOOD",
"state": "NJ",
"postal_code": "074503233",
"telephone_number": "201-655-5434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 N MAPLE AVE",
"address_2": "SUITE 301",
"city": "RIDGEWOOD",
"state": "NJ",
"postal_code": "074503233",
"telephone_number": "201-655-5434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERGOZ",
"first_name": "ELIZABETH",
"middle_name": "E",
"credential": "PH D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-28",
"last_updated": "2021-08-24",
"certification_date": "2021-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "0117161",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "4253",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "VERGOZ-REKIS",
"middle_name": "E",
"credential": "PH D",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Ridgewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.