Cerebral Medical Group, P.a.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

CEREBRAL MEDICAL GROUP, P.A.

Practice address

820 Bear Tavern Rd Ste 305
Ewing, NJ 08628-1021

Phone

(415) 403-2156

Fax

(415) 651-3458

NPI assigned

Oct 26, 2021

Organization subpart

No

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

Authorized official

Name

Michael Boggs, MD

Title

President

Phone

(415) 489-9369

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1528722543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2093 PHILADELPHIA PIKE # 9898",
            "city": "CLAYMONT",
            "state": "DE",
            "postal_code": "197032424",
            "telephone_number": "415-403-2156",
            "fax_number": "415-651-3458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 BEAR TAVERN RD STE 305",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086281021",
            "telephone_number": "415-403-2156",
            "fax_number": "415-651-3458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEREBRAL MEDICAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-26",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "BOGGS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-489-9369",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.