Individual provider Active NPI

Parviz Yeroushalmi, M.D.

  • Psychiatry Physician
  • Moorestown, NJ
National Provider Identifier
1609968742
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C50391 Issued in CA
Practice address
121 N Church St
Moorestown, NJ 08057-2424
Phone
(856) 217-9995
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X C50391 CA Primary

Addresses

Primary practice location

121 N Church St
Moorestown, NJ 08057-2424

Mailing address

PO Box 881188
San Diego, CA 92168-1188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151119002489 CA Practitioner - Psychiatry 2062564610 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50391CAMDPharmacist
C50391CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Butte CurrentSince Jul 11, 2018 Accepting new patients
County of Butte Current Accepting new patients
County of San Diego Current Accepting new patients
County of San Diego CurrentSince Oct 21, 2015 Accepting new patients
County of Butte CurrentSince Jul 11, 2018 Accepting new patients
County of San Diego CurrentSince Oct 21, 2015 Accepting new patients

Locations

3217 Cohasset Rd
Cohasset, CA 95973
Phone (530) 552-4578

1000 Broadway
Ste 210
El Cajon, CA 92021
Phone (619) 401-5500

995 Spruce St
Gridley, CA 95948
Phone (530) 846-7305

3177 Ocean View Blvd
San Diego, CA 92113
Phone (619) 231-9300

3853 Rosecrans St
San Diego, CA 92110
Phone (619) 615-0439

1250 Morena Blvd
San Diego, CA 92110
Phone (619) 692-8715

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1609968742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 881188",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921681188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N CHURCH ST",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080572424",
            "telephone_number": "856-217-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEROUSHALMI",
        "first_name": "PARVIZ",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C50391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

Verify at the official NPI Registry.