Individual provider Active NPI

Frank R Ferrise, PSY.D.

  • Clinical Psychologist
  • Livingston, NJ
National Provider Identifier
1851472674
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
S101257 Issued in NJ
Practice address
629 W Mount Pleasant Ave
Livingston, NJ 07039-1609
Phone
(973) 422-9888
Fax
(973) 422-9840
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X S101257 NJ Primary

Addresses

Primary practice location

629 W Mount Pleasant Ave
Livingston, NJ 07039-1609

Mailing address

629 W Mount Pleasant Ave
Livingston, NJ 07039-1609
Phone (973) 422-9888

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
I20050427000141 NJ Practitioner - Clinical Psychologist 0042259368 Practice locations: Livingston, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

629 W Mount Pleasant Ave
Livingston, NJ 07039-1609
Phone (973) 422-9888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S101257NJMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851472674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 W MOUNT PLEASANT AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070391609",
            "telephone_number": "973-422-9888",
            "fax_number": "973-422-9840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 W MOUNT PLEASANT AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070391609",
            "telephone_number": "973-422-9888",
            "fax_number": "973-422-9840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRISE",
        "first_name": "FRANK",
        "middle_name": "R",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "S101257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.