Individual provider Active NPI

Traian Adrian Zisu, M.D.

  • Psychiatry Physician
  • Ridgewood, NJ
National Provider Identifier
1639293103
Registry record updated Sep 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA06552100 Issued in NJ
Practice address
265 Ackerman Ave
Ridgewood, NJ 07450-4200
Phone
(201) 447-5630
Fax
(201) 447-0903
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25MA06552100 NJ Primary
Geriatric Psychiatry Physician 2084P0805X 25MA06552100 NJ

Addresses

Primary practice location

265 Ackerman Ave
Ridgewood, NJ 07450-4200

Mailing address

252 7TH Ave Apt 5E
New York, NY 10001-7331
Phone (212) 842-8443

Other identifiers 1

IdentifierTypeStateIssuer
7305508MedicaidNJ

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101213000167 NJ Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 6002003332 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Geriatric Psychiatry
Education
Other, 1990
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
David N. Rosenfeld, M.D. P.a.Group PAC ID 6103006580, 3 clinicians

Practice addresses (Care Compare)

265 Ackerman Ave
Ridgewood, NJ 07450-4203

Merit-based Incentive Payment System (MIPS)

Final score
18.53 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
61.77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06552100NJMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
David N. Rosenfeld, M.D., P.a. P.C. Psychiatry CurrentSince Sep 10, 2011 Accepting new patients
David N. Rosenfeld, M.D., P.a. Psychiatry CurrentSince Sep 10, 2011 Accepting new patients
Revitalizing Remedies LLC Psychiatry CurrentSince May 30, 2022 Accepting new patients
Integrated Psychological Services LLC CurrentSince May 30, 2022 Accepting new patients

Locations

52 Newton Sparta Rd
Newton, NJ 07860
Phone (201) 727-3241

265 Ackerman Ave
Ridgewood, NJ 07450
Phone (201) 447-5630

265 Ackerman Ave
Ste 202
Ridgewood, NJ 07450
Phone (201) 444-6226

255 Lafayette Ave
Suffern, NY 10901
Phone (845) 357-7830

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1639293103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 7TH AVE APT 5E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100017331",
            "telephone_number": "212-842-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 ACKERMAN AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504200",
            "telephone_number": "201-447-5630",
            "fax_number": "201-447-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZISU",
        "first_name": "TRAIAN",
        "middle_name": "ADRIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA06552100",
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NJ",
            "license": "25MA06552100",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7305508",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

Verify at the official NPI Registry.