Mason Shepherd, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35SI00652900 Issued in NJ

Practice address

636 Edpas Rd
New Brunswick, NJ 08901-3811

Phone

(973) 303-9237

NPI assigned

Oct 16, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Scott a. Roth, Psy.D., LLCGroup PAC ID 4486832953, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Mid-Atlantic Psychological Services

  • Adolescent and Children Mental Health Clinic/Center
  • Highland Park, NJ
  • NPI 1508503038
  Medicare reassignment NPD Authorized official
• Scott a. Roth, Psy.D., LLC

  • Psychologist
  • Cranbury, NJ
  • NPI 1205128188
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1558903005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 EDPAS RD",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089013811",
            "telephone_number": "973-303-9237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 EDPAS RD",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089013811",
            "telephone_number": "973-303-9237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "MASON",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-16",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00652900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farooq Muhammad Sheikh
• Casey Shein, PA
• Susan C Shen-Schwarz, M.B.,B.S.
• Eric H Shen
• Angelika Shenkerman, APN
• David Curry Shepperly, MD
• Bridget Sheridan
• Jonathan H Sherman, MD
• Richard A. Sherman, M.D.
• Yekaterina Sherman, MD

• Clinical Psychologist in New Brunswick, NJ
• Providers in New Brunswick, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.