Individual provider Active NPI

Olga Diamantis, PSY.D.

  • Psychologist
  • Edison, NJ
National Provider Identifier
1396142519
Registry record updated Dec 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35S100537800 Issued in NJ
Practice address
295 Pierson Ave
Edison, NJ 08837-3118
Phone
(732) 494-8558
Fax
(732) 494-8969
NPI assigned
Dec 3, 2014
Last updated
Dec 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35S100537800 NJ Primary

Addresses

Primary practice location

295 Pierson Ave
Edison, NJ 08837-3118

Mailing address

295 Pierson Ave
Edison, NJ 08837-3118
Phone (732) 494-8558

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
I20260422001137 NJ Practitioner - Clinical Psychologist 3173099702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

35 Amboy Ave
Metuchen, NJ 08840-2578
Phone (848) 200-2118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35S100537800NJMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Om Psychotherapy Group, LLC Psychologist Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417564800000",
    "number": "1396142519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 PIERSON AVE",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088373118",
            "telephone_number": "732-494-8558",
            "fax_number": "732-494-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 PIERSON AVE",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088373118",
            "telephone_number": "732-494-8558",
            "fax_number": "732-494-8969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAMANTIS",
        "first_name": "OLGA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-03",
        "last_updated": "2014-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35S100537800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.