Jeremy Schwarzbaum, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35SI00594500 Issued in NJ

Practice address

3900 Church Rd
Mount Laurel, NJ 08054

Phone

(800) 774-5516

Fax

(856) 429-4755

NPI assigned

Jan 6, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bancroft, a New Jersey Nonprofit CorporationGroup PAC ID 3476842824, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bancroft, a New Jersey Nonprofit Corporation

  • Rehabilitation Clinic/Center
  • Cherry Hill, NJ
  • NPI 1720121106
  Medicare reassignment Care Compare group NPD
• Optimal Mental Health & Wellness, PLLC

  • Adult Mental Health Clinic/Center
  • Jenkintown, PA
  • NPI 1003776295
  NPD (past)

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

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1295191294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 CALDWELL RD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080343220",
            "telephone_number": "800-774-5516",
            "fax_number": "856-429-4755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 CHURCH RD",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "08054",
            "telephone_number": "800-774-5516",
            "fax_number": "856-429-4755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8400 Roosevelt Blvd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191522081",
            "country_code": "US",
            "telephone_number": "215-333-7562",
            "fax_number": "215-333-7563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHWARZBAUM",
        "first_name": "JEREMY",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-06",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS017989",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PA",
            "license": "PS017989",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00594500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Schranz, CNM
• Adam Louis Schreiber, D.O.
• Abagail Schultes, PT, DPT
• David Schwartz
• Henry M Schwartz, PHARMD
• Senior Care of South Jersey
• Laurie Marie Sentman, PTA
• Hyoung Suk Seo, D.M.D
• Wansuk Seth Seo, D.M.D.
• Jennifer Sepede, D.O.

• Clinical Psychologist in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; 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.

Verify at the official NPI Registry.