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BERGEN PSYCHIATRIC CARE LLC
NPI 1295255149
Psychiatry & Neurology - Child & Adolescent Psychiatry in Ridgewood, NJ

Active since June 21, 2017
65 N MAPLE AVE STE 104, RIDGEWOOD, NJ 07450(201) 956-9483(201) 288-5262 Get Directions Write a Review

NPPES record last updated: March 18, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 18, 2019, Jun 21, 2017 (2 updates tracked since 2017).

About Bergen Psychiatric Care Llc NPPES

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

BERGEN PSYCHIATRIC CARE LLC (NPI 1295255149) is a healthcare organization registered as a child & adolescent psychiatry in Ridgewood, New Jersey and active in the NPI registry since June 2017. The organization lists Mini Thomas, Ccrp, as its authorized official.

NPPES Registry Identity

NPI1295255149
Entity TypeOrganization
Primary Taxonomy2084P0804X
Legal Business NameBERGEN PSYCHIATRIC CARE LLC
Location Address65 N MAPLE AVE STE 104Ridgewood, NJ 07450-3233
Mailing Address65 N Maple Ave Ste 104Ridgewood, NJ 07450-3233 · (201) 956-9483 · Fax (201) 288-5262
Phone(201) 956-9483
Fax(201) 288-5262
Organization SubpartNo
Authorized OfficialMini ThomasCcrp · (201) 956-9483
Enumeration DateJune 21, 2017
Last NPPES UpdateMarch 18, 20192 updates tracked since enumeration
✔ NPI 1295255149 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Also ListedPsychiatry & Neurology · Addiction MedicineTaxonomy 2084A0401X
65 N MAPLE AVE STE 104, Ridgewood, NJ 07450
Open in Google Maps ↗

Other Identifiers 1

Other25MA09523700NJ · State Licence

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bergen Psychiatric Care 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 Bergen Psychiatric Care LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Manoj Puthiyathu
Psychiatry
NPI 1649408956
230 E RIDGEWOOD AVE
Paramus, NJ 07652
(201) 967-4132
✔ PECOS✔ Accepts Medicare3.3 mi

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 Bergen Psychiatric Care LLC's NPI number?

The NPI number for Bergen Psychiatric Care LLC is 1295255149. It was assigned to this organization in the NPPES registry on June 21, 2017.

Where is Bergen Psychiatric Care LLC located?

Bergen Psychiatric Care LLC is located at 65 N Maple Ave Ste 104, Ridgewood, NJ 07450. The listed phone number is (201) 956-9483.

What is Bergen Psychiatric Care LLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Bergen Psychiatric Care LLC enrolled in Medicare?

Yes. Bergen Psychiatric Care LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Bergen Psychiatric Care LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Psychiatry) reassigns their Medicare billing to Bergen Psychiatric Care 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 Bergen Psychiatric Care LLC was last updated on March 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.