Randy Simon, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35S100509000 Issued in NJ

Practice address

80 Park St
Montclair, NJ 07042-2904

Phone

(201) 341-0593

NPI assigned

Nov 18, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2017 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Om Psychological Services

  • Clinical Psychologist
  • Summit, NJ
  • NPI 1073474466
  NPD (past)

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1619307238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 PARK ST",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422904",
            "telephone_number": "201-341-0593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 PARK ST",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422904",
            "telephone_number": "201-341-0593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "467 Springfield Ave",
            "address_purpose": "LOCATION",
            "city": "Summit",
            "state": "NJ",
            "postal_code": "079012622",
            "country_code": "US",
            "telephone_number": "201-341-0593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "RANDY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35S100509000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gretchen M Silver, D.C.
• Kenneth Silvestri, ED.D.
• Barbara Jane Sime
• Kara N Simmons
• Lynn Simon, OTR, CHT
• Simply Speech Services LLC
• Pamela Singh, DMD
• Sandra Antoinette Sinicropi, LCSW
• Jonathan Siskind, D.O.
• James Friere Skiba Sr., D.D.S.

• Clinical Psychologist in Montclair, NJ
• Providers in Montclair, 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 Jul 21, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.