Individual provider Active NPI

Alexandra Ranieri-Deniken, PSY.D.

  • Clinical Psychologist
  • Mount Laurel, NJ
National Provider Identifier
1487980942
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00564300 Issued in NJ
Practice address
100 Century Pkwy Ste 350
Mount Laurel, NJ 08054-1149
Phone
(856) 482-9000
Fax
(856) 482-1159
NPI assigned
Oct 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 35SI00564300 NJ Primary
Clinical Psychologist 103TC0700X PS-016696 PA

Addresses

Primary practice location

100 Century Pkwy Ste 350
Mount Laurel, NJ 08054-1149

Mailing address

100 Century Pkwy Ste 350
Mount Laurel, NJ 08054-1149
Phone (856) 482-9000

Other identifiers 1

IdentifierTypeStateIssuer
0665886MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aranierideniken249050@directvirtua.org

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
I20230323000272 NJ Practitioner - Clinical Psychologist 8426422957 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
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

100 Century Pkwy
Mount Laurel, NJ 08054-1149

3242 Route 206
Bordentown, NJ 08505-4517

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35SI00564300NJMDClinical Psychologist
PS-016696PAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Current Accepting new patients
Virtua Medical Group, PA CurrentSince Jun 5, 2023 Accepting new patients
Special People in Northeast, Inc. Past Accepting new patients
Special People in Northeast, Inc. Past Accepting new patients
Rowansom Nmi Osteopathic Manipulative Medicine Past Accepting new patients
Rowansom Newjersey Institute for Successful Aging-Geriatric Psychiatry Past Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

100 Century Pkwy
Ste 350
Mount Laurel, NJ 08054
Phone (856) 482-9000

42 E Laurel Rd
Ste 1700
Stratford, NJ 08084
Phone (856) 482-9000

Organizations & group practices 6

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": "1255910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1487980942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CENTURY PKWY STE 350",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541149",
            "telephone_number": "856-482-9000",
            "fax_number": "856-482-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CENTURY PKWY STE 350",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541149",
            "telephone_number": "856-482-9000",
            "fax_number": "856-482-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANIERI-DENIKEN",
        "first_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-19",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00564300",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS-016696",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0665886",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aranierideniken249050@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Century Pkwy Ste 350",
            "city": "Mount Laurel",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080541149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

Verify at the official NPI Registry.