Graham Jeffrey Hartke, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

5014 Issued in NJ

Practice address

104 Eagle Rock Ave
Roseland, NJ 07068-1324

Phone

(973) 885-6315

Fax

(973) 251-9461

NPI assigned

Oct 8, 2012

Sex

Male

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 Jun 14, 2019 through Jun 14, 2027

Medicare enrollment (NPD)

Not enrolled

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.

• West Essex Psychological Associates, LLC

  • Psychologist
  • Roseland, NJ
  • NPI 1841612280
  NPD (past) Authorized official

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360195200000",
    "number": "1659623197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 EAGLE ROCK AVE",
            "city": "ROSELAND",
            "state": "NJ",
            "postal_code": "070681324",
            "telephone_number": "973-885-6315",
            "fax_number": "973-251-9461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 EAGLE ROCK AVE",
            "city": "ROSELAND",
            "state": "NJ",
            "postal_code": "070681324",
            "telephone_number": "973-885-6315",
            "fax_number": "973-251-9461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTKE",
        "first_name": "GRAHAM",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-08",
        "last_updated": "2013-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "5014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eugene S Gorman, MD
• Julia C Grande, RD
• Harold Green
• Jeffrey Hall, M.D.
• Sabrina Hammond, LCSW
• Healthy Habitats, LLC
• Marissa Ann Hellermann, RDN
• Carrie Hennessy, BCBA
• High Point Physical Therapy LP
• Jennifer Hoehn, LCSW

• All providers in Roseland, NJ
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; 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.