Individual provider Active NPI

Jose Vazquez, M.D.

  • Psychiatry Physician
  • Princeton, NJ
National Provider Identifier
1427142520
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA04318400 Issued in NJ
Practice address
905 Herrontown Rd
Princeton House Behavioral Health
Princeton, NJ 08540-1901
Phone
(609) 497-3300
Fax
(609) 497-3370
NPI assigned
Oct 3, 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
Psychiatry Physician 2084P0800X 25MA04318400 NJ Primary

Addresses

Primary practice location

905 Herrontown Rd
Princeton House Behavioral Health
Princeton, NJ 08540-1901

Mailing address

3626 US Highway 1
Princeton, NJ 08540-5922
Phone (609) 243-0445

Other identifiers 1

IdentifierTypeStateIssuer
3840701MedicaidNJ

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
I20040804001383 NJ Practitioner - Psychiatry 4981675782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Princeton House Provider Group LLCGroup PAC ID 0244540540, 45 clinicians

Practice addresses (Care Compare)

1 Plainsboro Rd
Plainsboro, NJ 08536-1913
Phone (609) 497-3300

1460 Livingston Ave
BLDG 100
North Brunswick, NJ 08902-1873
Phone (732) 729-3600

905 Herrontown Rd
Princeton, NJ 08540-1901
Phone (609) 497-3300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18553NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton House Provider Group LLC Psychiatry CurrentSince Sep 1, 2015 Accepting new patients
Center at 353 PastSince Feb 1, 2017 Accepting new patients
Princeton Healthcare System, a New Jersey Non-Profit Corporation Past Accepting new patients

Locations

993 Lenox Dr
Ste 207
Lawrenceville, NJ 08648

1460 Livingston Ave
Bldg 100
North Brunswick, NJ 08902
Phone (732) 729-3600

905 Herrontown Rd
Princeton, NJ 08540
Phone (609) 497-3300

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427142520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3626 US HIGHWAY 1",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085405922",
            "telephone_number": "609-243-0445",
            "fax_number": "609-452-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 HERRONTOWN RD",
            "address_2": "PRINCETON HOUSE BEHAVIORAL HEALTH",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401901",
            "telephone_number": "609-497-3300",
            "fax_number": "609-497-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "JOSE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA04318400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3840701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.