Individual provider Active NPI

Ruth Mollod, PH.D.

  • Psychologist
  • Wayne, NJ
National Provider Identifier
1649360207
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35SI00184900 Issued in NJ
Practice address
2025 Hamburg Tpke
Suite B-1
Wayne, NJ 07470-6260
Phone
(973) 838-4023
NPI assigned
Oct 13, 2006
Sex
Female
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35SI00184900 NJ Primary
Psychologist 103T00000X 010653-1 NY

Addresses

Primary practice location

2025 Hamburg Tpke
Suite B-1
Wayne, NJ 07470-6260

Mailing address

611 Mountain Rd
Kinnelon, NJ 07405-2128
Phone (973) 838-4023

Other identifiers 1

IdentifierTypeStateIssuer
051369OtherNJVALUE OPTIONS

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
I20070626000039 NJ Practitioner - Clinical Psychologist 2860459682 Practice locations: Wayne, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2025 Hamburg Tpke
B1
Wayne, NJ 07470-6250
Phone (973) 838-4023

2025 Hamburg Tpke
Suite B 1
Wayne, NJ 07470-6260

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010653-1NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649360207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 MOUNTAIN RD",
            "city": "KINNELON",
            "state": "NJ",
            "postal_code": "074052128",
            "telephone_number": "973-838-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 HAMBURG TPKE",
            "address_2": "SUITE B-1",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074706260",
            "telephone_number": "973-838-4023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLOD",
        "first_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00184900",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "010653-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "051369",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.