Active NPI
Rachel Kisver
- Clinical Psychologist
- Mountainside, NJ
National Provider Identifier
1659796597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 35SI00492400
- Practice address
- 150 New Providence Rd
Mountainside, NJ 07092-2590 - Phone
- (888) 244-5373
- NPI assigned
- Mar 2, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS016906 | PA | |
| Clinical Psychologist | 103TC0700X | 35SI00492400 | NJ | Primary |
Addresses
Primary practice location
150 New Providence Rd
Mountainside, NJ 07092-2590
Mailing address
150 New Providence Rd
Mountainside, NJ 07092-2590
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2006
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1899 W Custer LN
Fayetteville, AZ 72701-6777
66 W Gilbert St
Tinton Falls, NJ 07701-4948
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00492400 | NJ | MD | Clinical Psychologist |
| PS016906 | PA | MD | Clinical Psychologist |
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.
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- NPI 1396886297
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543795200000",
"number": "1659796597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 NEW PROVIDENCE RD",
"city": "MOUNTAINSIDE",
"state": "NJ",
"postal_code": "070922590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 NEW PROVIDENCE RD",
"city": "MOUNTAINSIDE",
"state": "NJ",
"postal_code": "070922590",
"telephone_number": "888-244-5373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISVER",
"first_name": "RACHEL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-02",
"last_updated": "2018-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS016906",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "35SI00492400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountainside, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.