Individual provider Active NPI

Peter Reavey, PHD

  • Psychologist
  • Summit, NJ
National Provider Identifier
1962894899
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35S100664500 Issued in NJ
Practice address
482 Springfield Ave # 210
Summit, NJ 07901-2601
Phone
(908) 273-5558
Fax
(908) 273-3355
NPI assigned
Mar 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35S100664500 NJ Primary

Addresses

Primary practice location

482 Springfield Ave # 210
Summit, NJ 07901-2601

Mailing address

PO Box 502
Belmar, NJ 07719-0502
Phone (732) 418-8729

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
I20231023000327 NJ Practitioner - Clinical Psychologist 9032565494 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Psychological Services PAGroup PAC ID 9032213483, 12 clinicians

Practice addresses (Care Compare)

482 Springfield Ave
FL 2
Summit, NJ 07901-2601
Phone (908) 273-5558

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35S100664500NJMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Psychological Services PA Psychologist CurrentSince Oct 1, 2023 Accepting new patients
Om Psychological Services CurrentSince Mar 1, 2026 Accepting new patients
Comprehensive Psychology System PC Psychologist Past Accepting new patients

Locations

482 Springfield Ave
#210
Summit, NJ 07901
Phone (908) 273-5558

482 Springfield Ave
Fl 2
Summit, NJ 07901
Phone (908) 273-5558

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.

NPI Registry JSON

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1962894899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 502",
            "city": "BELMAR",
            "state": "NJ",
            "postal_code": "077190502",
            "telephone_number": "732-418-8729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 SPRINGFIELD AVE # 210",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079012601",
            "telephone_number": "908-273-5558",
            "fax_number": "908-273-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAVEY",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-02",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35S100664500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.