Individual provider Active NPI

Elizabeth Groisser, PSYD

  • Clinical Psychologist
  • Montclair, NJ
National Provider Identifier
1699790188
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
016199 Issued in NY
Practice address
21 Plymouth St
Montclair, NJ 07042-2607
Phone
(201) 341-4926
Fax
(973) 746-1922
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 016199 NY Primary

Addresses

Primary practice location

21 Plymouth St
Montclair, NJ 07042-2607

Mailing address

48 S Park St
Montclair, NJ 07042-2777
Phone (201) 341-4926

Other identifiers 1

IdentifierTypeStateIssuer
02638291MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Saddlebrook Anesthesia Services, P.C. Past Accepting new patients

Organizations & group practices 1

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285113600000",
    "number": "1699790188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 S PARK ST",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422777",
            "telephone_number": "201-341-4926",
            "fax_number": "973-746-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 PLYMOUTH ST",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422607",
            "telephone_number": "201-341-4926",
            "fax_number": "973-746-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROISSER",
        "first_name": "ELIZABETH",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2010-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02638291",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.