Individual provider Active NPI

Sally Ann Berry, MD, PHD

  • Psychiatry Physician
  • Somerset, NJ
National Provider Identifier
1881832129
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
046358 Issued in GA
Practice address
15 Tamarack Rd
Somerset, NJ 08873-2922
Phone
(609) 865-6816
NPI assigned
Jan 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 046358 GA Primary

Addresses

Primary practice location

15 Tamarack Rd
Somerset, NJ 08873-2922

Mailing address

15 Tamarack Rd
Somerset, NJ 08873-2922
Phone (609) 865-6816

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190716000398 NJ Practitioner - Psychiatry 3577898493 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
046358GAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health - Behavioral Health Psychiatry Current Accepting new patients
Rutgers Health - Behavioral Health Psychiatry CurrentSince Dec 20, 2020 Accepting new patients

Locations

183 S Orange Ave
Newark, NJ 07103
Phone (973) 972-0004

671 Hoes Ln W
Rm D3381
Piscataway, NJ 08854
Phone (732) 235-3289

Organizations & group practices 2

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": "1232755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1881832129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 TAMARACK RD",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088732922",
            "telephone_number": "609-865-6816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 TAMARACK RD",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088732922",
            "telephone_number": "609-865-6816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "SALLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-24",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "046358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

Verify at the official NPI Registry.