Individual provider Active NPI

Reuben E. Gross

  • Clinical Psychologist
  • Teaneck, NJ
National Provider Identifier
1871640409
Registry record updated Sep 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
851 Issued in NJ
Practice address
961 Teaneck Rd
Teaneck, NJ 07666-4510
Phone
(201) 837-0066
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2012

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 851 NJ Primary

Addresses

Primary practice location

961 Teaneck Rd
Teaneck, NJ 07666-4510

Mailing address

1299 Wellington Ave
Teaneck, NJ 07666-2111
Phone (201) 837-0066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: No
  • 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
I20260612001440 NJ Practitioner - Psychologist Billing Independently 4284673435 Practice locations: Teaneck, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1299 Wellington Ave
Teaneck, NJ 07666-2111
Phone (201) 218-3112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
851NJMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pat David Biondi Ma-Ccca 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.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348444800000",
    "number": "1871640409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1299 WELLINGTON AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076662111",
            "telephone_number": "201-837-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 TEANECK RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664510",
            "telephone_number": "201-837-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "REUBEN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2012-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.