Individual provider Active NPI

Jeffrey D Belgrave, PH.D.

  • Clinical Psychologist
  • Lafayette, NJ
National Provider Identifier
1316034762
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00203300 Issued in NJ
Practice address
15 State Route 15
Lafayette, NJ 07848-2007
Phone
(973) 579-6700
NPI assigned
Oct 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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 Psychologist 103TC0700X 35SI00203300 NJ Primary

Addresses

Primary practice location

15 State Route 15
Lafayette, NJ 07848-2007

Mailing address

49 Willow Ave
Rockaway, NJ 07866-2825
Phone (973) 586-9872

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
I20050629000934 NJ Practitioner - Clinical Psychologist 6507802576 Practice locations: Sparta, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

156 Woodport Rd
Suite 1B
Sparta, NJ 07871-2331
Phone (973) 224-6973

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35SI00203300NJMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316034762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 WILLOW AVE",
            "city": "ROCKAWAY",
            "state": "NJ",
            "postal_code": "078662825",
            "telephone_number": "973-586-9872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 STATE ROUTE 15",
            "city": "LAFAYETTE",
            "state": "NJ",
            "postal_code": "078482007",
            "telephone_number": "973-579-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELGRAVE",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00203300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, NJ

Sources for this page

Verify at the official NPI Registry.