DR. JACQUELINE SHALL-MCCUMISKEY PSY. D.
NPI 1083160170
Psychologist - Clinical in Marlton, NJ

Q: What is Jacqueline Shall-mccumiskey's NPI number?

The NPI number for Jacqueline Shall-mccumiskey is 1083160170. It was assigned to this individual provider in the NPPES registry on August 29, 2016.

Q: What is Jacqueline Shall-mccumiskey's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since August 29, 2016PECOS EnrolledAccepts Medicare Assignment

525 ROUTE 73 N STE 104, MARLTON, NJ 08053(646) 479-8068 Get Directions Write a Review

NPPES record last updated: September 29, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 29, 2022, May 5, 2022, Aug 29, 2016 (3 updates tracked since 2016).

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About Dr. Jacqueline Shall-mccumiskey Psy. D. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACQUELINE SHALL-MCCUMISKEY PSY. D. (NPI 1083160170) is an individual clinical provider in Marlton, New Jersey, licensed in New York (021797) and active in the NPI registry since August 2016. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1083160170

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. JACQUELINE SHALL-MCCUMISKEYCredential: PSY. D.

Location Address525 ROUTE 73 N STE 104Marlton, NJ 08053-3422

Mailing Address1675 Richmond RdStaten Island, NY 10304-2317 · (646) 479-8068

Phone(646) 479-8068

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateAugust 29, 2016

Last NPPES UpdateSeptember 29, 20223 updates tracked since enumeration

NPPES CertifiedSeptember 29, 2022

✔ NPI 1083160170 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in NY · 021797

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

525 ROUTE 73 N STE 104, Marlton, NJ 08053

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Secondary Practice Locations 2

Location 11110 South Ave, Suite 5Staten Island, NY 10314-3403 · Phone (347) 273-1290

Location 21675 Richmond RdStaten Island, NY 10304-2317 · Phone (646) 479-8068

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jacqueline Shall-mccumiskey Psy. D. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5597043141

PECOS Enrollment IDI20230207000025

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08053 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$185.05 typical visit price

range $61.59 – $185.05

Typical copayment $46.26 (range $15.39 – $46.26)

Most-billed visit code 99205

Established Patient

$107.94 typical visit price

range $20.08 – $150.98

Typical copayment $26.98 (range $5.02 – $37.74)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARA SETTIPANI PH.D.

Psychologist (Clinical Child & Adolescent)