Individual provider Active NPI

Kenneth Charles Schneider, PH.D.

  • Psychologist
  • Springfield, NJ
National Provider Identifier
1376628057
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1325 Issued in NJ
Practice address
675 Morris Ave
Springfield, NJ 07081-1525
Phone
(973) 467-9409
Fax
(974) 467-9410
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

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
Psychologist 103T00000X 1325 NJ Primary

Addresses

Primary practice location

675 Morris Ave
Springfield, NJ 07081-1525

Mailing address

675 Morris Ave
Springfield, NJ 07081-1525
Phone (973) 467-9409

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
I20050526000413 NJ Practitioner - Clinical Psychologist 8628010915 Practice locations: Springfield, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

675 Morris Ave
Suite 202
Springfield, NJ 07081-1523
Phone (973) 467-9409

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1325NJMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
M Mintz K Schneider R Morris Etal Psychologist Past Accepting new patients
Psychological Associates of North Jersey LLC Past Accepting new patients

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376628057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 MORRIS AVE",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811525",
            "telephone_number": "973-467-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 MORRIS AVE",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811525",
            "telephone_number": "973-467-9409",
            "fax_number": "974-467-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "KENNETH",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "1325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, NJ

Sources for this page

Verify at the official NPI Registry.