Organization Active NPI

Synapse Wellness

  • Psychiatry Physician
  • Edison, NJ
National Provider Identifier
1275355596
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SYNAPSE WELLNESS
Practice address
629 Amboy Ave FL 3
Edison, NJ 08837-3579
Phone
(848) 219-1602
NPI assigned
Oct 28, 2024
Last updated
Oct 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Authorized official

Name
Ibrahim Alsherief, DONPI 1497338099
Title
Medical Director
Phone
(848) 219-1602

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

629 Amboy Ave FL 3
Edison, NJ 08837-3579

Mailing address

32 Koster Blvd Apt 1B
Edison, NJ 08837-4272
Phone (848) 219-1602

Other practice location 1

240 Patchogue Yaphank Rd Ste 211
East Patchogue, NY 11772-4894
Phone (848) 219-1602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250620002848 NJ Part B Supplier - Clinic/Group Practice 7810409323 Receives reassigned benefits from 1 practitioner
Practice locations: Edison, NJ

National Provider Directory

National Provider Directory

Locations

629 Amboy Ave
Ste 307
Edison, NJ 08837
Phone (848) 219-1602

240 Patchogue Yaphank Rd
Ste 211
East Patchogue, NY 11772
Phone (631) 758-2815

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1275355596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 KOSTER BLVD APT 1B",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088374272",
            "telephone_number": "848-219-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 AMBOY AVE FL 3",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088373579",
            "telephone_number": "848-219-1602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 Patchogue Yaphank Rd Ste 211",
            "address_purpose": "LOCATION",
            "city": "East Patchogue",
            "state": "NY",
            "postal_code": "117724894",
            "country_code": "US",
            "telephone_number": "848-219-1602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SYNAPSE WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "ALSHERIEF",
        "authorized_official_first_name": "IBRAHIM",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "848-219-1602",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.