Individual provider Active NPI

Miriam A. Burt, PSY.D.

  • Clinical Psychologist
  • Jersey City, NJ
National Provider Identifier
1467711218
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00533600 Issued in NJ
Practice address
220 9TH St Ste 2041
Jersey City, NJ 07302-4288
Phone
(201) 733-4277
Fax
(201) 353-2318
NPI assigned
May 15, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35SI00533600 NJ
Clinical Psychologist 103TC0700X 35SI00533600 NJ Primary

Addresses

Primary practice location

220 9TH St Ste 2041
Jersey City, NJ 07302-4288

Mailing address

305 10TH St
Jersey City, NJ 07302-1300
Phone (201) 780-4217

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
I20250902001045 NJ Practitioner - Clinical Psychologist 9739680612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

220 9TH St
Suite 2041
Jersey City, NJ 07302-4288
Phone (201) 477-0095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35SI00533600NJMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gold Coast Psychological Services, PC Psychologist CurrentSince Jul 11, 2025 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1467711218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 10TH ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073021300",
            "telephone_number": "201-780-4217",
            "fax_number": "201-353-2318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 9TH ST STE 2041",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024288",
            "telephone_number": "201-733-4277",
            "fax_number": "201-353-2318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURT",
        "first_name": "MIRIAM",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-15",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00533600",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00533600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.