Individual provider Active NPI

Georgianna Dart, PSY.D.

  • Clinical Neuropsychologist
  • Edison, NJ
National Provider Identifier
1750644324
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
4987 Issued in NJ
Practice address
65 James St
Center for Head Injuries
Edison, NJ 08820-3947
Phone
(732) 321-7000
Fax
(732) 321-7921
NPI assigned
Jun 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 4987 NJ Primary
Clinical Neuropsychologist 103G00000X 018878 NY

Addresses

Primary practice location

65 James St
Center for Head Injuries
Edison, NJ 08820-3947

Mailing address

65 James St
Center for Head Injuries
Edison, NJ 08820-3947
Phone (732) 321-7000

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
I20130118000208 NJ Practitioner - Clinical Psychologist 8820241136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2060 Oak Tree Rd
Suite 3
Edison, NJ 08820-2058
Phone (732) 626-4526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4987NJMDClinical Neuropsychologist
018878NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Neuropsychology and Counseling Center, LLC Clinical Neuropsychologist CurrentSince Oct 1, 2017 Accepting new patients
Community Hospital Group Inc Past Accepting new patients

Locations

2060 Oak Tree Rd
Ste 3
Edison, NJ 08820
Phone (732) 616-0609

Interoperability endpoints

  • Direct secure messaging: georgianna.dart@direct.hackensackmeridian.org

Organizations & group practices 2

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": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1750644324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 JAMES ST",
            "address_2": "CENTER FOR HEAD INJURIES",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203947",
            "telephone_number": "732-321-7000",
            "fax_number": "732-321-7921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 JAMES ST",
            "address_2": "CENTER FOR HEAD INJURIES",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203947",
            "telephone_number": "732-321-7000",
            "fax_number": "732-321-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DART",
        "first_name": "GEORGIANNA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NJ",
            "license": "4987",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "018878",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.