Individual provider Active NPI

Brian Amorello, PH.D., LPC

  • Psychologist
  • Ridgewood, NJ
National Provider Identifier
1447773544
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35SI00589000 Issued in NJ
Practice address
20 Wilsey SQ
Ridgewood, NJ 07450-3793
Phone
(973) 767-9384
NPI assigned
Jul 20, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PC00500500 NJ
Psychologist 103T00000X 35SI00589000 NJ Primary

Addresses

Primary practice location

20 Wilsey SQ
Ridgewood, NJ 07450-3793

Mailing address

100 South Pkwy
Clifton, NJ 07014-1412
Phone (973) 767-9384

Other practice location 1

11 Dundar Rd
Springfield, NJ 07081-3553
Phone (973) 767-9384

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
I20180710000726 NJ Practitioner - Clinical Psychologist 9335495126 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lukin Center for Psychotherapy and Advancement PCGroup PAC ID 4183849052, 3 clinicians

Practice addresses (Care Compare)

20 Wilsey SQ
FL 1
Ridgewood, NJ 07450-3793
Phone (201) 409-0393

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37PC00500500NJMDProfessional Counselor
35SI00589000NJMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jun 1, 2018 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jun 1, 2018 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

360 Essex St
Hackensack, NJ 07601
Phone (201) 336-8686

Interoperability endpoints

  • Direct secure messaging: brian.amorello@direct.hackensackmeridian.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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.

NPI Registry JSON

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

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1447773544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SOUTH PKWY",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070141412",
            "telephone_number": "973-767-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 WILSEY SQ",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503793",
            "telephone_number": "973-767-9384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Dundar Rd",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "NJ",
            "postal_code": "070813553",
            "country_code": "US",
            "telephone_number": "973-767-9384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMORELLO",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "PH.D., LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00500500",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00589000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

Verify at the official NPI Registry.