Individual provider Active NPI

Ketnie V Aristide

  • Psychiatric/Mental Health Nurse Practitioner
  • Hoboken, NJ
National Provider Identifier
1003471293
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01454100 Issued in NJ
Practice address
221 River St Ste 9
Hoboken, NJ 07030-5990
Phone
(201) 308-8252
NPI assigned
May 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ01454100 NJ Primary
Registered Nurse 163W00000X 7588191 NY

Addresses

Primary practice location

221 River St Ste 9
Hoboken, NJ 07030-5990

Mailing address

170 William St
New York, NY 10038-2612

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230406000314 NJ Practitioner - Nurse Practitioner 6103291075 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7588191NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates of New Jersey, LLC CurrentSince May 11, 2024 Accepting new patients
Aldad Medical NJ, P.C CurrentSince Mar 7, 2023 Accepting new patients
Wagner Medical PC Psychiatric/Mental Health CurrentSince Jul 23, 2025 Accepting new patients

Locations

820 Bear Tavern Rd
Ewing, NJ 08628
Phone (415) 205-1229

221 River St
Ste 901
Hoboken, NJ 07030
Phone (201) 308-8252

116 Village Blvd
Ste 200
Princeton, NJ 08540
Phone (609) 285-3094

1400 Hooper Ave
Ste 2
Toms River, NJ 08753
Phone (732) 339-3398

510 Hempstead Tpke
Rm 203
West Hempstead, NY 11552
Phone 51650572001051

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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": "1556841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1003471293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 WILLIAM ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100382612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 RIVER ST STE 9",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305990",
            "telephone_number": "201-308-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARISTIDE",
        "first_name": "KETNIE",
        "middle_name": "V",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-03",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01454100",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "7588191",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

Verify at the official NPI Registry.