Marcel Kaganovskaya, DNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ01158200 Issued in NJ

Practice address

131 Overpeck Ave
Ridgefield Park, NJ 07660-1855

Phone

(201) 667-2197

NPI assigned

Apr 20, 2016

Last updated

May 5, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mindful Cognition PCGroup PAC ID 9739527938, 4 clinicians

Serv Centers of New Jersey, IncGroup PAC ID 8820983117, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Mindful Cognition PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Ridgefield Park, NJ
  • NPI 1912615428

  Family

  Medicare reassignment Care Compare group NPD Authorized official
• Serv Centers of New Jersey, Inc

  dba Clifton Family Outpatient Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clifton, NJ
  • NPI 1356454615
  Medicare reassignment Care Compare group NPD
• Serv Centers of New Jersey, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Clifton, NJ
  • NPI 1700549680
  NPD

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714867200000",
    "number": "1417301094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W KINGSBRIDGE RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104683904",
            "telephone_number": "570-540-2590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 OVERPECK AVE",
            "city": "RIDGEFIELD PARK",
            "state": "NJ",
            "postal_code": "076601855",
            "telephone_number": "201-667-2197"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 W Kingsbridge Rd",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104683904",
            "country_code": "US",
            "telephone_number": "570-540-2590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAGANOVSKAYA",
        "first_name": "MARCEL",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-20",
        "last_updated": "2024-05-05",
        "certification_date": "2024-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "340371",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F404375",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01158200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrated Therapeutic Services
• Integrated Therapeutic Services
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• Kendra Jones, DOULA
• June Seongeun Jung, APN
• Susan Y Kasparov, PHARMD
• Danielle Renee Kelly, RNC, IBCLC
• Keystone Treatment Center
• Paul K Kim, D.V.M.
• Annalise Korbul

• Psychiatric/Mental Health Nurse Practitioner in Ridgefield Park, NJ
• Providers in Ridgefield Park, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2024; 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.