Active NPI
Alan Gettis, PH.D.
- Clinical Psychologist
- River Edge, NJ
National Provider Identifier
1780760686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1109
- Practice address
- 117 Kinderkamack Rd
River Edge, NJ 07661-1941 - Phone
- (201) 488-1808
- Fax
- (201) 488-3096
- NPI assigned
- Oct 31, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1109 | NJ | Primary |
Addresses
Primary practice location
117 Kinderkamack Rd
River Edge, NJ 07661-1941
Mailing address
117 Kinderkamack Rd
River Edge, NJ 07661-1941
Phone (201) 488-1808
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050630000123 | NJ | Practitioner - Clinical Psychologist | 7214973254 | Practice locations: Norwood, NJ |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1974
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
59 Pierson Ave
Norwood, NJ 07648-2428
Phone (201) 403-3097
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1109 | NJ | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780760686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 KINDERKAMACK RD",
"city": "RIVER EDGE",
"state": "NJ",
"postal_code": "076611941",
"telephone_number": "201-488-1808",
"fax_number": "201-488-3096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 KINDERKAMACK RD",
"city": "RIVER EDGE",
"state": "NJ",
"postal_code": "076611941",
"telephone_number": "201-488-1808",
"fax_number": "201-488-3096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GETTIS",
"first_name": "ALAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "1109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in River Edge, NJ
- Robert James Gallo, M.D.
- Garden State Acupuncture & Herbs PC (River Edge Acupuncture & Herbal Medicine)
- Christine Louise Gares, OTR/L
- Loren M Gelberg-Goff, LCSW
- Paula A Gencarelli, D.M.D.
- Nanette Joan Gettis, MSW, LCSW
- Caryn Gewirtzman, BCBA
- Jessica Glass, LPC
- Mark S Goldfarb, MD
- Jeffrey M Gordon, D.M.D.,M.M.SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.