Individual provider Active NPI

Abraham Kuperberg, PH.D.

  • Psychologist
  • Fair Lawn, NJ
National Provider Identifier
1629128327
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2050 Issued in NJ
Practice address
2-31 Summit Ave
Fair Lawn, NJ 07410-2043
Phone
(201) 796-2014
Fax
(888) 453-1609
NPI assigned
Jan 12, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2050 NJ Primary

Addresses

Primary practice location

2-31 Summit Ave
Fair Lawn, NJ 07410-2043

Mailing address

2-31 Summit Ave
Fair Lawn, NJ 07410-2043
Phone (201) 796-2014

Other identifiers 1

IdentifierTypeStateIssuer
0742007MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, FL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20040325000286 NY Practitioner - Clinical Psychologist 9234021486 Practice locations: Loch Sheldrake, NY
I20120228000020 NJ Practitioner - Clinical Psychologist 9234021486 Practice locations: Mahwah, NJ
I20221209001594 FL Practitioner - Clinical Psychologist 9234021486 Practice locations: Boca Raton, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22 Zahava Circle
Loch Sheldrake, NY 12759
Phone (845) 627-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2050NJMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Abraham Kuperberg, PH.D. Psychologist PastSince Nov 17, 2022 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, 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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629128327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2-31 SUMMIT AVE",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102043",
            "telephone_number": "201-796-2014",
            "fax_number": "888-453-1609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2-31 SUMMIT AVE",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102043",
            "telephone_number": "201-796-2014",
            "fax_number": "888-453-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPERBERG",
        "first_name": "ABRAHAM",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "2050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0742007",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

Verify at the official NPI Registry.