Individual provider Active NPI

Randeep Gill, PSYD

  • Clinical Psychologist
  • Passaic, NJ
National Provider Identifier
1437977931
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00758200 Issued in NJ
Practice address
85 Crescent Ave
Passaic, NJ 07055-2437
Phone
(973) 264-0023
Fax
(973) 264-0022
NPI assigned
Oct 2, 2024
Last updated
Oct 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 35SI00758200 NJ Primary

Addresses

Primary practice location

85 Crescent Ave
Passaic, NJ 07055-2437

Mailing address

2719 Hollywood Blvd Ste 5469
Hollywood, FL 33020-4821
Phone (973) 264-0023

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
I20241021001022 NJ Practitioner - Clinical Psychologist 7618409244 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Positive BeginningsGroup PAC ID 3678837358, 14 clinicians
Senior Care Therapy LLCGroup PAC ID 0547335366, 140 clinicians

Practice addresses (Care Compare)

2003 Lincoln Dr W
Suite B
Marlton, NJ 08053-1529
Phone (856) 886-8839

85 Crescent Ave
Passaic, NJ 07055-2437
Phone (973) 264-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35SI00758200NJMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Beginnings CurrentSince Oct 1, 2024 Accepting new patients
Senior Care Therapy LLC Clinical CurrentSince Oct 1, 2024 Accepting new patients

Locations

2719 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 354-2555

2003 Lincoln Dr W
Ste B
Marlton, NJ 08053
Phone (856) 886-8839

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, 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": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1437977931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2719 HOLLYWOOD BLVD STE 5469",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204821",
            "telephone_number": "973-264-0023",
            "fax_number": "973-264-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 CRESCENT AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070552437",
            "telephone_number": "973-264-0023",
            "fax_number": "973-264-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "RANDEEP",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-02",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00758200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

Verify at the official NPI Registry.