Active NPI
Olga Magidina Nikelshpur, PH.D,
- Clinical Neuropsychologist
- Hackensack, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 35SI00622100
- Practice address
- 360 Essex St Ste 303
Hackensack, NJ 07601-8566 - Phone
- (917) 769-6557
- NPI assigned
- Nov 19, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 020815 -1 | NY | |
| Clinical Neuropsychologist | 103G00000X | 35SI00622100 | NJ | Primary |
Addresses
Primary practice location
360 Essex St Ste 303
Hackensack, NJ 07601-8566
Mailing address
360 Essex St Ste 303
Hackensack, NJ 07601-8566
Phone (917) 769-6557
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
360 Essex St
Hackensack, NJ 07601-8550
Phone (201) 336-8686
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.33 of 100
- Quality
- 66.38
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.39
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00622100 | NJ | MD | Clinical Neuropsychologist |
| 020815 -1 | NY | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hackensack Meridian Health Medical Group - Specialty Care PC | Current | Accepting new patients | |
| Hackensack Meridian Health Medical Group - Specialty Care PC | Current | Accepting new patients | |
| Hackensack Meridian Health Medical Group - Complex Care PC | Past | Accepting new patients |
Locations
360 Essex St
Ste 303
Hackensack, NJ 07601
Phone (551) 996-3091
360 Essex St
Hackensack, NJ 07601
Phone (201) 336-8686
30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066
3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463
650 From Rd
Paramus, NJ 07652
Phone (201) 639-6620
Interoperability endpoints
- olga.nikelshpur@direct.hackensackmeridian.org
- https://fhir4.healow.com/fhir/r4/IHJHBD
Organizations & group practices 3
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.
-
dba HMHMG Specialty Care
- Surgical Critical Care Physician
- Red Bank, NJ
- NPI 1215989249
-
dba HMMG New Jersey Oral & Maxillofacial Surgery
- Durable Medical Equipment & Medical Supplies
- North Bergen, NJ
- NPI 1215734199
-
dba HMHMG Complex Care
- Internal Medicine Physician
- Red Bank, NJ
- NPI 1154379626
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579824000000",
"number": "1891192852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "360 ESSEX ST STE 303",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076018566",
"telephone_number": "917-769-6557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 ESSEX ST STE 303",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076018566",
"telephone_number": "917-769-6557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIKELSHPUR",
"first_name": "OLGA",
"middle_name": "MAGIDINA",
"credential": "PH.D,",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-19",
"last_updated": "2020-01-24",
"certification_date": "2020-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "020815 -1",
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "NJ",
"license": "35SI00622100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hackensack, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.