Individual provider Active NPI

Elliot M Gore, PH.D.

  • Psychologist
  • Manalapan, NJ
National Provider Identifier
1306870407
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1633 Issued in NJ
Practice address
80 Bridge Plaza Dr
Manalapan, NJ 07726-1700
Phone
(732) 786-1700
Fax
(732) 972-6014
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
Yes

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
Psychologist 103T00000X 1633 NJ Primary

Addresses

Primary practice location

80 Bridge Plaza Dr
Manalapan, NJ 07726-1700

Mailing address

7 Crown CT
Manalapan, NJ 07726-4301
Phone (732) 972-1681

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
I20120315000636 NJ Practitioner - Clinical Psychologist 8224297999 Practice locations: Margate City, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

23 S Coolidge Ave
Apt C
Margate City, NJ 08402-2264
Phone (732) 740-1405

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1633NJMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa F. Ligammari, LCSW, L.L.C. PastSince Jul 1, 2018 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306870407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CROWN CT",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077264301",
            "telephone_number": "732-972-1681",
            "fax_number": "732-972-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 BRIDGE PLAZA DR",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077261700",
            "telephone_number": "732-786-1700",
            "fax_number": "732-972-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORE",
        "first_name": "ELLIOT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "1633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manalapan, NJ

Sources for this page

Verify at the official NPI Registry.