Active NPI
Judy Lynn Kaufman, PH.D.
- Psychologist
- Englewood, NJ
National Provider Identifier
1790809697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- S1001192
- Practice address
- 163 Engle St
Building 2
Englewood, NJ 07631-2535 - Phone
- (201) 871-9101
- Fax
- (201) 541-8599
- NPI assigned
- Mar 17, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | S1001192 | NJ | Primary |
Addresses
Primary practice location
163 Engle St
Building 2
Englewood, NJ 07631-2535
Mailing address
163 Engle St
Building 2
Englewood, NJ 07631-2535
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 3, 2021 through May 3, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005038 | NY | MD | Mental Health Counselor |
| S1001192 | NJ | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nicola Weiss, PH.D., LLC | Past | 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.
-
- Clinical Psychologist
- Englewood, NJ
- NPI 1487716916
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790809697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "163 ENGLE ST",
"address_2": "BUILDING 2",
"city": "ENGLEWOOD",
"state": "NJ",
"postal_code": "076312535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "163 ENGLE ST",
"address_2": "BUILDING 2",
"city": "ENGLEWOOD",
"state": "NJ",
"postal_code": "076312535",
"telephone_number": "201-871-9101",
"fax_number": "201-541-8599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUFMAN",
"first_name": "JUDY",
"middle_name": "LYNN",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "S1001192",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Englewood, NJ
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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.