KRISHNA ANDERSON PHD LLC
NPI 1063790764
Clinic/Center - Mental Health (Including Community Mental Health Center) in Midland Park, NJ
About Krishna Anderson Phd Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KRISHNA ANDERSON PHD LLC (NPI 1063790764) is a healthcare organization registered as a mental health (including community mental health center) in Midland Park, New Jersey and active in the NPI registry since July 2011. The organization lists Krishna Anderson, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Krishna Anderson Phd Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Krishna Anderson Phd LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Krishna Anderson Phd LLC's NPI number?
The NPI number for Krishna Anderson Phd LLC is 1063790764. It was assigned to this organization in the NPPES registry on July 28, 2011.
Where is Krishna Anderson Phd LLC located?
Krishna Anderson Phd LLC is located at 323 Godwin Ave, Midland Park, NJ 07432. The listed phone number is (201) 444-3533.
What is Krishna Anderson Phd LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.
Is Krishna Anderson Phd LLC enrolled in Medicare?
Yes. Krishna Anderson Phd LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Krishna Anderson Phd LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Krishna Anderson Phd LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Krishna Anderson Phd LLC was last updated on January 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Krishna Anderson Phd Llc · NPI 1063790764
Mental Health (Including Community Mental Health Center) organization in Midland Park, New Jersey. Organization record, active in the CMS NPPES registry since July 28, 2011.
## Identity
- **NPI:** 1063790764 (Entity type: Organization)
- **Enumerated:** July 28, 2011
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Organization subpart:** No
- **Authorized official:** Krishna Anderson, OWNER
## Practice location
- **Address:** 323 GODWIN AVE, Midland Park, NJ 07432-1534
- **Phone:** (201) 444-3533 · **Fax:** (201) 652-9748
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Clinical Psychologist) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 14, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1063790764) · Data from the CMS NPPES public registry.