Individual provider Active NPI

Edward Kardell, PSYD

  • Clinical Child & Adolescent Psychologist
  • Lakewood, NJ
National Provider Identifier
1306933304
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
35SI00360800 Issued in NJ
Practice address
700 Airport Rd
Lakewood, NJ 08701-5907
Phone
(732) 367-4700
Fax
(732) 364-2253
NPI assigned
Oct 10, 2006
Sex
Male
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 Child & Adolescent Psychologist 103TC2200X 35SI00360800 NJ Primary

Addresses

Primary practice location

700 Airport Rd
Lakewood, NJ 08701-5907

Mailing address

700 Airport Rd
P.O. Box 2036
Lakewood, NJ 08701-5907
Phone (732) 367-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190204000050 TX Practitioner - Clinical Psychologist 9436496163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.17 of 100Reported as group
Quality
83.48
Improvement activities
40
Cost
67.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35SI00360800NJMDClinical Child & Adolescent Psychologist
38030TXMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Deer Oaks Geriatric Services P C CurrentSince Jan 14, 2019 Accepting new patients
Deer Oaks Mental Health Associates PC Past Accepting new patients

Locations

7272 Wurzbach Rd
Ste 706
San Antonio, TX 78240
Phone (210) 615-3401

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306933304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 AIRPORT RD",
            "address_2": "P.O. BOX 2036",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015907",
            "telephone_number": "732-367-4700",
            "fax_number": "732-364-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 AIRPORT RD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015907",
            "telephone_number": "732-367-4700",
            "fax_number": "732-364-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARDELL",
        "first_name": "EDWARD",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NJ",
            "license": "35SI00360800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.