NPIMap

Organization Active NPI

Red Bank Neurorehabilitation Associates, LLC

  • Clinical Neuropsychologist
  • Red Bank, NJ
National Provider Identifier
1780930834
Registry record updated Nov 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
RED BANK NEUROREHABILITATION ASSOCIATES, LLC
Practice address
12 Reckless PL
Red Bank, NJ 07701-1704
Phone
(908) 692-9485
NPI assigned
Jul 26, 2012
Last updated
Nov 7, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2012

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

Authorized official

Name
Dr. Joseph Marcantuono, PH.D.NPI 1801902523
Title
Clinical Psychologist/Partner
Phone
(908) 692-9485

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103G00000X Primary
Counseling PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC1900X
Rehabilitation PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TR0400X

Addresses

Primary practice location

12 Reckless PL
Red Bank, NJ 07701-1704

Mailing address

12 Reckless PL
Red Bank, NJ 07701-1704
Phone (908) 692-9485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121112000089 NJ Part B Supplier - Clinic/Group Practice 6800047259 Receives reassigned benefits from 1 practitioner
Practice locations: Red Bank, NJ

National Provider Directory

National Provider Directory

Locations

1040 Route 36
#One
Atlantic Highlands, NJ 07716
Phone (732) 291-3400

12 Reckless Pl
Red Bank, NJ 07701
Phone (732) 729-3600

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1343260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352246400000",
    "number": "1780930834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 RECKLESS PL",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011704",
            "telephone_number": "908-692-9485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 RECKLESS PL",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011704",
            "telephone_number": "908-692-9485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED BANK NEUROREHABILITATION ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-26",
        "last_updated": "2012-11-07",
        "status": "A",
        "authorized_official_last_name": "MARCANTUONO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST/PARTNER",
        "authorized_official_telephone_number": "908-692-9485",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.