Individual provider Active NPI

Marvin Barry Chartoff, ED.D

  • Psychologist
  • Sparta, NJ
National Provider Identifier
1962440420
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35SI00104400 Issued in NJ
Practice address
21 Main St
Sparta, NJ 07871-1916
Phone
(973) 729-5535
Fax
(973) 726-9706
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 35SI00104400 NJ
Clinical Psychologist 103TC0700X 35SI00104400 NJ
Clinical Child & Adolescent Psychologist 103TC2200X 35SI00104400 NJ
Psychologist 103T00000X 35SI00104400 NJ Primary

Addresses

Primary practice location

21 Main St
Sparta, NJ 07871-1916

Mailing address

11S Shore TRL
Sparta, NJ 07871-1610
Phone (862) 432-2971

Other identifiers 2

IdentifierTypeStateIssuer
0318108MedicaidNJ
222664938OtherTAX ID

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
I20050525000169 NJ Practitioner - Clinical Psychologist 3375585854 Practice locations: Long Valley, NJ; Parsippany, NJ; Sparta, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11 S Shore Trail
Sparta, NJ 07871-1610

11 S Shore TRL
Sparta, NJ 07871-1610

1279 US Hwy 46
Parsippany, NJ 07054-4904
Phone (973) 402-2575

21 Main St
Sparta, NJ 07871-1916
Phone (973) 729-5535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35SI00104400NJMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Psychotherapists Psychologist 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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1962440420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11S SHORE TRL",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078711610",
            "telephone_number": "862-432-2971",
            "fax_number": "973-726-9706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MAIN ST",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078711916",
            "telephone_number": "973-729-5535",
            "fax_number": "973-726-9706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARTOFF",
        "first_name": "MARVIN",
        "middle_name": "BARRY",
        "name_prefix": "Dr.",
        "credential": "ED.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NJ",
            "license": "35SI00104400",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00104400",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NJ",
            "license": "35SI00104400",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00104400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0318108",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "222664938",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, NJ

Sources for this page

Verify at the official NPI Registry.