Tyreasea Anicha Johnson-Mason, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ00429100 Issued in NJ

Practice address

215 Highland Ave Ste 100
Haddon Township, NJ 08108-2634

Phone

(609) 350-4792

Fax

(856) 823-1922

NPI assigned

Apr 19, 2013

Last updated

Apr 15, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Acina Behavioral Health Solutions LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Audubon, NJ
  • NPI 1982000741
  Medicare reassignment NPD Authorized official
• JMS Behavioral Health Inc.

  • Psychiatric/Mental Health Nurse Practitioner
  • Haddon Township, NJ
  • NPI 1306577887
  Medicare reassignment NPD Authorized official
• Women of Hope Resource Center, Inc

  • Community/Behavioral Health Agency
  • Atco, NJ
  • NPI 1740456656
  Medicare reassignment
• Vericare Behavioral Health of New Jersey, P.a.

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1669408274

  Psychiatric/Mental Health

  NPD (past)

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1003250101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 HIGHLAND AVE STE 100",
            "city": "HADDON TOWNSHIP",
            "state": "NJ",
            "postal_code": "081082634",
            "telephone_number": "609-350-4792",
            "fax_number": "856-823-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 HIGHLAND AVE STE 100",
            "city": "HADDON TOWNSHIP",
            "state": "NJ",
            "postal_code": "081082634",
            "telephone_number": "609-350-4792",
            "fax_number": "856-823-1922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2250 Chapel Ave W",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080022051",
            "country_code": "US",
            "telephone_number": "856-482-9000",
            "fax_number": "856-482-1159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON-MASON",
        "first_name": "TYREASEA",
        "middle_name": "ANICHA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-19",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP012833",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00429100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0379077",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1003250101",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inadvance Medicine Associates East (Passport Health)
• Infinity Empowerment Services
• Erik Jervis, LSW
• JMD Psychological Services, LLC
• JMS Behavioral Health Inc.
• Megan Kirby
• Kovacs-Farkas Counseling LLC
• Michael Koval, PHARMD
• Tejal Kundaikar
• Charlene Kwintner, LCSW

• Psychiatric/Mental Health Nurse Practitioner in Haddon Township, NJ
• Providers in Haddon Township, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.