Individual provider Active NPI

Henry Wesley Ratliff, M.D.

  • Psychiatry Physician
  • Princeton, NJ
National Provider Identifier
1336185537
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA03747700 Issued in NJ
Practice address
601 Ewing St
Suite a-8
Princeton, NJ 08540-2757
Phone
(609) 921-2689
Fax
(609) 279-1745
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25MA03747700 NJ Primary

Addresses

Primary practice location

601 Ewing St
Suite a-8
Princeton, NJ 08540-2757

Mailing address

101 Bertrand Dr
Princeton, NJ 08540-2903
Phone (609) 924-6072

Other identifiers 1

IdentifierTypeStateIssuer
3839303MedicaidNJ

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100428000774 NJ Practitioner - PsychiatryPractitioner - Addiction Medicine 1759418494 Practice locations: Princeton, NJ

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
University of Texas Southwestern Medical School at Dallas, 1973
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

601 Ewing St
Princeton, NJ 08540-2754
Phone (609) 921-2689

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA03747700NJMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Jersey Arthritis and Osteoporosis, LLC PastSince Jan 1, 2011 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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365033600000",
    "number": "1336185537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BERTRAND DR",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085402903",
            "telephone_number": "609-924-6072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 EWING ST",
            "address_2": "SUITE A-8",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085402757",
            "telephone_number": "609-921-2689",
            "fax_number": "609-279-1745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATLIFF",
        "first_name": "HENRY",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2013-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA03747700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3839303",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.