Active NPI
Sandra L Squires, MD
- Psychiatry Physician
- Newton, NJ
National Provider Identifier
1720057946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MAO58291
- Practice address
- 175 High St
Newton, NJ 07860-1004 - Phone
- (973) 579-8975
- Fax
- (973) 579-8423
- NPI assigned
- Mar 17, 2006
- Last updated
- Aug 4, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MAO58291 | NJ | Primary |
Addresses
Primary practice location
175 High St
Newton, NJ 07860-1004
Mailing address
175 High St
40 Park Place
Newton, NJ 07860-1004
Phone (973) 579-8975
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5603005 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MAO58291 | NJ | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inhealth PA | Psychiatry | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280880000000",
"number": "1720057946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 HIGH ST",
"address_2": "40 PARK PLACE",
"city": "NEWTON",
"state": "NJ",
"postal_code": "078601004",
"telephone_number": "973-579-8975",
"fax_number": "973-579-8423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 HIGH ST",
"city": "NEWTON",
"state": "NJ",
"postal_code": "078601004",
"telephone_number": "973-579-8975",
"fax_number": "973-579-8423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SQUIRES",
"first_name": "SANDRA",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-17",
"last_updated": "2010-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NJ",
"license": "MAO58291",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5603005",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.