Derek P Aita, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35SI00307900 Issued in NJ

Practice address

10 E Mount Vernon Ave
Haddonfield, NJ 08033-2325

Phone

(856) 795-3598

Fax

(856) 795-3948

NPI assigned

Feb 26, 2007

Last updated

Jul 8, 2007By 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, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Instrumental Change LLC

  • Clinical Social Worker
  • Merchantville, NJ
  • NPI 1700169687
  NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801922398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 MCKENDIMEN RD",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080559774",
            "telephone_number": "609-268-7945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E MOUNT VERNON AVE",
            "city": "HADDONFIELD",
            "state": "NJ",
            "postal_code": "080332325",
            "telephone_number": "856-795-3598",
            "fax_number": "856-795-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AITA",
        "first_name": "DEREK",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00307900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Acw Health Care, Inc.
• Advanced Radiology of Haddonfield PA
• Advanced Radiology of Haddonfield PA
• Advocare, LLC (Advocare Grove Family Medical Associates)
• Advocare, LLC (Advocare Haddonfield Pediatric Association)
• Alexia Totoro Counseling LLC (Standing Hope and Faith Counseling)
• Allergy & Asthma Care, PA
• Lauren Marie Allison, CRNP
• Amy E James DMD PA
• Gabriela Andrade, M.D.

• Clinical Psychologist in Haddonfield, NJ
• Providers in Haddonfield, NJ by specialty
• Clinical Psychologist in New Jersey

• 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.

Verify at the official NPI Registry.