Active NPI
Cristina Shaheen, PSY.D.
- Psychologist
- Metuchen, NJ
National Provider Identifier
1225396161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 35SI00541600
- Practice address
- 296 Amboy Ave
Metuchen, NJ 08840-2471 - Phone
- (732) 784-3536
- Fax
- (732) 784-3532
- NPI assigned
- Apr 29, 2012
- Reactivated
- Apr 7, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 35SI00541600 | NJ | Primary |
| Psychologist | 103T00000X | 5416 | NJ |
Addresses
Primary practice location
296 Amboy Ave
Metuchen, NJ 08840-2471
Mailing address
296 Amboy Ave
Metuchen, NJ 08840-2471
Phone (732) 784-3536
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
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
185
36 BLDG a Suite 115
West Long Branch, NJ 07764-1339
Phone (732) 784-3536
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00541600 | NJ | MD | Psychologist |
| 5416 | NJ | MD | Psychologist |
Organizations & group practices 1
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.
-
- Clinical Neuropsychologist
- Metuchen, NJ
- NPI 1073086591
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683590400000",
"number": "1225396161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "296 AMBOY AVE",
"city": "METUCHEN",
"state": "NJ",
"postal_code": "088402471",
"telephone_number": "732-784-3536",
"fax_number": "732-784-3632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "296 AMBOY AVE",
"city": "METUCHEN",
"state": "NJ",
"postal_code": "088402471",
"telephone_number": "732-784-3536",
"fax_number": "732-784-3532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAHEEN",
"first_name": "CRISTINA",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-29",
"last_updated": "2023-05-09",
"certification_date": "2023-05-09",
"deactivation_date": "2021-01-05",
"reactivation_date": "2021-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "35SI00541600",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "5416",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Metuchen, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.