Kristine Cangelosi Keane, PSY.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

35SI00424500 Issued in NJ

Practice address

220 Jack Martin Blvd Ste E2
Brick, NJ 08724-7772

Phone

(732) 920-3434

Fax

(732) 920-2447

NPI assigned

Jul 8, 2005

Last updated

Jan 5, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Kristine Cangelosi Former name

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, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shore Psychological Healthcare LLCGroup PAC ID 6305846379, 15 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shore Psychological Healthcare LLC

  • Clinical Psychologist
  • Brick, NJ
  • NPI 1477563534
  Medicare reassignment Care Compare group NPD Authorized official
• Meridian Obstetrics and Gynecology Associates P C

  • Obstetrics & Gynecology Physician
  • Neptune, NJ
  • NPI 1396793907
  NPD (past)
• Senior Psychological Care Inc

  • Clinical Psychologist
  • Bridgewater, NJ
  • NPI 1013961531
  NPD (past)

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1316945942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 JACK MARTIN BLVD STE E2",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247772",
            "telephone_number": "732-920-3434",
            "fax_number": "732-920-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 JACK MARTIN BLVD STE E2",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247772",
            "telephone_number": "732-920-3434",
            "fax_number": "732-920-2447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "58 Maple Ave",
            "address_purpose": "LOCATION",
            "city": "Red Bank",
            "state": "NJ",
            "postal_code": "077011618",
            "country_code": "US",
            "telephone_number": "732-920-3434",
            "fax_number": "732-920-2447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEANE",
        "first_name": "KRISTINE",
        "middle_name": "CANGELOSI",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NJ",
            "license": "35SI00424500",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00424500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "CANGELOSI",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Randi Joy Katz, D.O.
• Nathan Kaufman, M.D
• Gurleen Kaur
• Christopher Kawa, D.C.
• Stephanie Kay-Estrella, BCBA
• Sile Keane
• Shawn Keating
• Mackenzie Keefe, PSY.D.
• Patrick Joseph Keelan, OD
• Jacqueline Carla Kelly-Gallello, DPT

• Clinical Neuropsychologist in Brick, NJ
• Providers in Brick, NJ by specialty
• Clinical Neuropsychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; 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.