Individual provider Active NPI

William John Ernst, PSY.D.

  • Clinical Neuropsychologist
  • Freehold, NJ
National Provider Identifier
1780892166
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
35SI00409100 Issued in NJ
Practice address
495 Iron Bridge Rd Ste 8
Freehold, NJ 07728-5306
Phone
(215) 262-0741
Fax
(609) 424-3164
NPI assigned
May 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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 35SI00409100 NJ Primary
Clinical Neuropsychologist 103G00000X PS015223 PA

Addresses

Primary practice location

495 Iron Bridge Rd Ste 8
Freehold, NJ 07728-5306

Mailing address

495 Iron Bridge Rd Ste 8
Freehold, NJ 07728-5306
Phone (215) 262-0741

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
I20040225000698 NJ Practitioner - Clinical Psychologist 1153217229

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4 Paragon Way
Suite 350
Freehold, NJ 07728-7946

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35SI00409100NJMDClinical Neuropsychologist
PS015223PAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Neuropsychology & Counseling Associates, LLC Clinical Neuropsychologist PastSince Nov 1, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1780892166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 IRON BRIDGE RD STE 8",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077285306",
            "telephone_number": "215-262-0741",
            "fax_number": "609-424-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 IRON BRIDGE RD STE 8",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077285306",
            "telephone_number": "215-262-0741",
            "fax_number": "609-424-3164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNST",
        "first_name": "WILLIAM",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NJ",
            "license": "35SI00409100",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "PA",
            "license": "PS015223",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

Verify at the official NPI Registry.