NPIMap

Organization Active NPI

Wayne Behavioral Service, LLC

  • Psychiatry Physician
  • Wayne, NJ
National Provider Identifier
1487677795
Registry record updated Jul 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
WAYNE BEHAVIORAL SERVICE, LLC
Practice address
401 Hamburg Tpke
Ste. 302
Wayne, NJ 07470-2139
Phone
(973) 790-9222
Fax
(973) 790-0671
NPI assigned
Jul 26, 2006
Last updated
Jul 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2014

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

Authorized official

Name
Mr. Mohamed A Elrafei, MDNPI 1114955895
Title
President
Phone
(973) 790-9222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

401 Hamburg Tpke
Ste. 302
Wayne, NJ 07470-2139

Mailing address

401 Hamburg Tpke
Suite 302
Wayne, NJ 07470-2154
Phone (973) 790-9222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061207000159 NJ Part B Supplier - Clinic/Group Practice 8820097561 Receives reassigned benefits from 53 practitioners
Practice locations: Ramsey, NJ; Wayne, NJ

National Provider Directory

National Provider Directory
Tax ID family
Wayne Behavioral Service LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

401 Hamburg Tpke
Ste 302
Wayne, NJ 07470
Phone (973) 790-9222

401 Hamburg Tpke
Ste 303
Wayne, NJ 07470
Phone (973) 595-0010

Practitioners & affiliated clinicians

Practitioners 61

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405987200000",
    "number": "1487677795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HAMBURG TPKE",
            "address_2": "SUITE 302",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702154",
            "telephone_number": "973-790-9222",
            "fax_number": "973-790-0671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HAMBURG TPKE",
            "address_2": "STE. 302",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702139",
            "telephone_number": "973-790-9222",
            "fax_number": "973-790-0671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE BEHAVIORAL SERVICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2014-07-22",
        "status": "A",
        "authorized_official_last_name": "ELRAFEI",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-790-9222",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.