Active NPI
Jeffrey H. Axelbank, PSY.D.
- Clinical Psychologist
- Highland Park, NJ
National Provider Identifier
1679670228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- SI003252
- Practice address
- 727 Raritan Ave
Highland Park, NJ 08904-2952 - Phone
- (732) 572-8848
- Fax
- (732) 572-7002
- NPI assigned
- Sep 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | SI003252 | NJ | Primary |
Addresses
Primary practice location
727 Raritan Ave
Highland Park, NJ 08904-2952
Mailing address
727 Raritan Ave
Highland Park, NJ 08904-2952
Phone (732) 572-8848
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6482902 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2025 through Oct 1, 2027
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
727 Raritan Ave
Highland Park, NJ 08904-2952
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SI003252 | NJ | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322524800000",
"number": "1679670228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "727 RARITAN AVE",
"city": "HIGHLAND PARK",
"state": "NJ",
"postal_code": "089042952",
"telephone_number": "732-572-8848",
"fax_number": "732-572-7002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "727 RARITAN AVE",
"city": "HIGHLAND PARK",
"state": "NJ",
"postal_code": "089042952",
"telephone_number": "732-572-8848",
"fax_number": "732-572-7002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AXELBANK",
"first_name": "JEFFREY",
"middle_name": "H.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-17",
"last_updated": "2011-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "SI003252",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6482902",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Highland Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- 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.