Individual provider Active NPI

John Michael Fiorello, PSY.D.

  • Clinical Psychologist
  • North Haledon, NJ
National Provider Identifier
1710259601
Registry record updated Aug 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00399400 Issued in NJ
Practice address
546 High Mountain Rd
North Haledon, NJ 07508-2606
Phone
(973) 727-2217
NPI assigned
Feb 7, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 35SI00399400 NJ Primary
Clinical Psychologist 103TC0700X 014623-1 NY

Addresses

Primary practice location

546 High Mountain Rd
North Haledon, NJ 07508-2606

Mailing address

272 Skyline Lakes Dr
Ringwood, NJ 07456-1960
Phone (973) 727-2217

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
I20050519000699 NJ Practitioner - Clinical Psychologist 2668413683 Reassigns benefits to 1 organization
Practice locations: Pompton Lakes, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

200 Wanaque Ave
Suite 203
Pompton Lakes, NJ 07442-2130

227 Hamburg Tpke
Suite 2
Pompton Lakes, NJ 07442-1838
Phone (973) 727-2217

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35SI00399400NJMDClinical Psychologist
014623-1NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Group LLC CurrentSince Mar 26, 2016 Accepting new patients
Vericare Behavioral Health of New Jersey, P.a. Clinical Past Accepting new patients
St Marys Hospital Past Accepting new patients

Locations

92 E Main St
Ste 411
Somerville, NJ 08876
Phone (908) 707-9700

Organizations & group practices 3

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": "1328572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1710259601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 SKYLINE LAKES DR",
            "city": "RINGWOOD",
            "state": "NJ",
            "postal_code": "074561960",
            "telephone_number": "973-727-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 HIGH MOUNTAIN RD",
            "city": "NORTH HALEDON",
            "state": "NJ",
            "postal_code": "075082606",
            "telephone_number": "973-727-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIORELLO",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-07",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00399400",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "014623-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Haledon, NJ

Sources for this page

Verify at the official NPI Registry.