Individual provider Active NPI

Andrew Nathaniel Greenberg, PSY.D.

  • Clinical Psychologist
  • Livingston, NJ
National Provider Identifier
1467790212
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00445900 Issued in NJ
Practice address
35 Coddington Ter
Livingston, NJ 07039-3633
Phone
(862) 812-0441
NPI assigned
Jan 29, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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 35SI00445900 NJ Primary

Addresses

Primary practice location

35 Coddington Ter
Livingston, NJ 07039-3633

Mailing address

35 Coddington Ter
Livingston, NJ 07039-3633
Phone (862) 812-0441

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
I20191104000975 NJ Practitioner - Clinical Psychologist 4688906191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

35 Coddington Ter
Livingston, NJ 07039-3633
Phone (862) 812-0441

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35SI00445900NJMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew Greenberg PSYD Clinical Psychologist LLC CurrentSince Jun 25, 2019 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": "1359417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571011200000",
    "number": "1467790212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 CODDINGTON TER",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070393633",
            "telephone_number": "862-812-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 CODDINGTON TER",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070393633",
            "telephone_number": "862-812-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "ANDREW",
        "middle_name": "NATHANIEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-29",
        "last_updated": "2019-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00445900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.