Active NPI
Rita Grogan, MD
- Psychiatry Physician
- Ridgewood, NJ
National Provider Identifier
1730395229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 25MA06082900
- Practice address
- 1250 East Ridgewood Ave
#B
Ridgewood, NJ 07450-3930 - Phone
- (201) 445-0506
- Fax
- (201) 612-8960
- NPI assigned
- May 14, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 25MA06082900 | NJ | Primary |
Addresses
Primary practice location
1250 East Ridgewood Ave
#B
Ridgewood, NJ 07450-3930
Mailing address
1250 East Ridgewood Ave
#B
Ridgewood, NJ 07450-3930
Phone (201) 445-0506
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: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 1, 2017 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA06082900 | NJ | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484179200000",
"number": "1730395229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 EAST RIDGEWOOD AVE",
"address_2": "#B",
"city": "RIDGEWOOD",
"state": "NJ",
"postal_code": "074503930",
"telephone_number": "201-445-0506",
"fax_number": "201-612-8960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 EAST RIDGEWOOD AVE",
"address_2": "#B",
"city": "RIDGEWOOD",
"state": "NJ",
"postal_code": "074503930",
"telephone_number": "201-445-0506",
"fax_number": "201-612-8960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROGAN",
"first_name": "RITA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-14",
"last_updated": "2017-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NJ",
"license": "25MA06082900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.