Individual provider Active NPI

Daniel Adam Noll, PHD

  • Psychologist
  • South Amboy, NJ
National Provider Identifier
1558327239
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5410 Issued in NJ
Practice address
16 Sand Piper Dr
South Amboy, NJ 08879-3426
Phone
(732) 306-9609
NPI assigned
Apr 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 5410 NJ Primary

Addresses

Primary practice location

16 Sand Piper Dr
South Amboy, NJ 08879-3426

Mailing address

16 Sand Piper Dr
South Amboy, NJ 08879-3426
Phone (732) 306-9609

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
I20150206000953 NJ Practitioner - Clinical Psychologist 4981633997 Practice locations: South Amboy, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

16 Sand Piper Dr
South Amboy, NJ 08879-3426
Phone (732) 306-9609

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
5410NJMDPsychologist
7013MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan Rothman, M.D. Past 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": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1558327239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 SAND PIPER DR",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088793426",
            "telephone_number": "732-306-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 SAND PIPER DR",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088793426",
            "telephone_number": "732-306-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLL",
        "first_name": "DANIEL",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-22",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "5410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Amboy, NJ

Sources for this page

Verify at the official NPI Registry.