Individual provider Active NPI

Anastasia Jean Bullock, PSY.D.

  • Psychologist
  • Camden, NJ
National Provider Identifier
1619480795
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35SI00586700 Issued in NJ
Practice address
1 Cooper PLZ
Camden, NJ 08103-1461
Phone
(856) 342-2000
NPI assigned
Nov 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35SI00586700 NJ Primary

Addresses

Primary practice location

1 Cooper PLZ
Camden, NJ 08103-1461

Mailing address

1 Federal St
Camden, NJ 08103-1088
Phone (856) 356-4924

Other practice location 1

3 Cooper Plz
Camden, NJ 08103-1438
Phone (856) 342-2000

Other names 1

  • Anastasia Jean Sokol Former name

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
I20171227002216 NJ Practitioner - Clinical Psychologist 4688932437 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cooper Physician Offices PAGroup PAC ID 2860396611, 326 clinicians

Practice addresses (Care Compare)

1 Cooper PLZ
Camden, NJ 08103-1461
Phone (856) 342-3150

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
81.58
Promoting interoperability
99.4
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35SI00586700NJMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Psychiatric Associates, PC CurrentSince Nov 4, 2019 Accepting new patients
Cooper Physician Offices, PA CurrentSince Dec 1, 2017 Accepting new patients

Locations

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

3 Cooper Plz
Rm 104
Camden, NJ 08103
Phone (609) 963-6770

3 Cooper Plz
Camden, NJ 08103
Phone (609) 342-2001

1 Federal St
Camden, NJ 08103
Phone (856) 338-3355

3 Cooper Plz
Rm 307
Camden, NJ 08103
Phone (856) 757-7799

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

1210 Brace Rd
Cherry Hill, NJ 08034
Phone (609) 428-6616

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1619480795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "856-342-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Cooper Plz",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "NJ",
            "postal_code": "081031438",
            "country_code": "US",
            "telephone_number": "856-342-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "ANASTASIA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-10",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00586700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANASTASIA",
            "last_name": "SOKOL",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.