John Bradley Fechter, PSYD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

35S100594200 Issued in NJ

Practice address

27 Clyde Rd Ste 102
Somerset, NJ 08873

Phone

(908) 418-1382

NPI assigned

Jun 7, 2018

Last updated

Jun 21, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Holy Name Primary Care and Specialty Associates PCGroup PAC ID 4082847447, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Holy Name Primary Care and Specialty Associates, PC

  • Psychiatry Physician
  • Teaneck, NJ
  • NPI 1104256130
  Medicare reassignment Care Compare group NPD
• New Jersey Neuropsychology, LLC

  • Clinic/Center
  • Somerset, NJ
  • NPI 1710471875
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1770076580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 E BROAD ST APT 8",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070905100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 CLYDE RD STE 102",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "08873",
            "telephone_number": "908-418-1382"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1199 Pleasant Valley Way",
            "address_purpose": "LOCATION",
            "city": "West Orange",
            "state": "NJ",
            "postal_code": "070521424",
            "country_code": "US",
            "telephone_number": "973-731-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FECHTER",
        "first_name": "JOHN",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-07",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NJ",
            "license": "35S100594200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jouliana Farag, PHARMD
• Heather Farino, FNP-C
• Nicole Farrales
• Allison Favale, PA-C
• Renata Favato-Cosenza, RT
• Robert P Fein, MD
• Barton M Feldman, PHARMACIST
• Paul Fellenbaum, M.D.
• Rachael Erica Felsenfeld, PSYD
• Evelyn Feng, MD

• Clinical Neuropsychologist in Somerset, NJ
• Providers in Somerset, NJ by specialty
• Clinical Neuropsychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.