Individual provider Active NPI

Nicola Weiss, PH.D.

  • Clinical Psychologist
  • Englewood, NJ
National Provider Identifier
1265594436
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3844 Issued in NJ
Practice address
416 Gloucester St
Englewood, NJ 07631-4706
Phone
(201) 320-7174
Fax
(800) 724-7270
NPI assigned
Dec 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 3844 NJ Primary

Addresses

Primary practice location

416 Gloucester St
Englewood, NJ 07631-4706

Mailing address

416 Gloucester St
Englewood, NJ 07631-4706
Phone (201) 320-7174

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
I20050114000083 NJ Practitioner - Clinical Psychologist 9537118724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nicola Weiss PHD LLCGroup PAC ID 0547219735, 3 clinicians

Practice addresses (Care Compare)

416 Gloucester St
Englewood, NJ 07631-4706
Phone (201) 320-7174

Merit-based Incentive Payment System (MIPS)

Final score
97.8 of 100Reported as individual
Quality
95
Improvement activities
40
Cost
82.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3844NJMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nicola Weiss, PH.D., LLC Clinical CurrentSince Sep 1, 2004 Accepting new patients
Debra a Turitz MSW, LCSW PastSince Sep 1, 2004 Accepting new patients

Locations

163 Engle St
Englewood, NJ 07631
Phone (201) 569-3313

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265594436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 GLOUCESTER ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314706",
            "telephone_number": "201-320-7174",
            "fax_number": "800-724-7270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 GLOUCESTER ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314706",
            "telephone_number": "201-320-7174",
            "fax_number": "800-724-7270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "NICOLA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "3844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.