Organization Active NPI

Mindful Cognition PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Ridgefield Park, NJ
National Provider Identifier
1912615428
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MINDFUL COGNITION PC
Practice address
131 Overpeck Ave
Ridgefield Park, NJ 07660-1855
Phone
(201) 667-2197
NPI assigned
Nov 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Authorized official

Name
Marcel Kaganovskaya, APNNPI 1417301094
Title
Ceo
Phone
(570) 540-2590

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

131 Overpeck Ave
Ridgefield Park, NJ 07660-1855

Mailing address

131 Overpeck Ave
Ridgefield Park, NJ 07660-1855
Phone (201) 667-2197

Other practice location 1

815 Gravesend Neck Rd
Brooklyn, NY 11223-5552
Phone (201) 667-2197

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240408001503 NJ Part B Supplier - Clinic/Group Practice 9739527938 Receives reassigned benefits from 6 practitioners
Practice locations: Upper Montclair, NJ

National Provider Directory

National Provider Directory

Locations

622 Valley Rd
Ste 5I
Upper Montclair, NJ 07043
Phone (201) 667-2197

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1912615428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 OVERPECK AVE",
            "city": "RIDGEFIELD PARK",
            "state": "NJ",
            "postal_code": "076601855",
            "telephone_number": "201-667-2197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 OVERPECK AVE",
            "city": "RIDGEFIELD PARK",
            "state": "NJ",
            "postal_code": "076601855",
            "telephone_number": "201-667-2197"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 Gravesend Neck Rd",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112235552",
            "country_code": "US",
            "telephone_number": "201-667-2197",
            "fax_number": "973-928-5290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINDFUL COGNITION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-14",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "KAGANOVSKAYA",
        "authorized_official_first_name": "MARCEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "570-540-2590",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.