Jed E Baker, PHD

Individual provider Active NPI Psychologist · Springfield, NJ

NPI 1962742932 · NPPES record last updated Feb 27, 2013

Key facts

NPI
1962742932
Entity type
Individual (NPI type 1)
Primary specialty
Psychologist 103T00000X
License
35SI00331400 (NJ)
Practice address
28 Millburn Ave, Suite 7
Springfield, NJ 07081
Phone
(973) 313-1803
NPI assigned
Feb 27, 2013
Sex
Male
Sole proprietor
Yes

Medicare Care Compare profile

Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

28 Millburn Ave
Suite 7
Springfield, NJ 07081-1023
Phone (973) 313-1803

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20170914000455 NJ Practitioner - Clinical Psychologist 7214201201 Practice locations: Springfield, NJ

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35SI00331400 NJ Yes

Addresses

Primary practice location

28 Millburn Ave, Suite 7
Springfield, NJ 07081

Mailing address

29 Collinwood Rd
Maplewood, NJ 07040-1035
Phone (973) 313-1803

Other providers in Springfield, NJ

All providers in Springfield, NJ · Psychologist in New Jersey

Sources for this page

Verify at the official NPI Registry.