NPIMap

Organization Active NPI

Freehold Psychiatric Associates

  • Psychiatry Physician
  • Freehold, NJ
National Provider Identifier
1356493712
Registry record updated Feb 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
FREEHOLD PSYCHIATRIC ASSOCIATES
Practice address
901 W Main St
Freehold, NJ 07728-2537
Phone
(732) 431-2000
NPI assigned
Jan 17, 2007
Last updated
Feb 21, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2011

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

Authorized official

Name
Pam McCabe
Title
Billing Manager
Phone
(732) 349-3838

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

901 W Main St
Freehold, NJ 07728-2537

Mailing address

PO Box 1247
Toms River, NJ 08754-1247
Phone (732) 349-3838

Other identifiers 1

IdentifierTypeStateIssuer
4625005MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110225000457 NJ Part B Supplier - Clinic/Group Practice 6406037324 Receives reassigned benefits from 12 practitioners
Practice locations: Freehold, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298246400000",
    "number": "1356493712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1247",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087541247",
            "telephone_number": "732-349-3838",
            "fax_number": "732-349-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W MAIN ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282537",
            "telephone_number": "732-431-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEHOLD PSYCHIATRIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2011-02-21",
        "status": "A",
        "authorized_official_last_name": "MCCABE",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "732-349-3838"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4625005",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.