Individual provider Active NPI

Jennifer Levitt, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Freehold, NJ
National Provider Identifier
1013251685
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00414700 Issued in NJ
Practice address
35 Court St Ste 1C
Freehold, NJ 07728-1709
Phone
(609) 582-4700
Fax
(279) 300-3710
NPI assigned
Nov 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00414700 NJ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ00414700 NJ Primary

Addresses

Primary practice location

35 Court St Ste 1C
Freehold, NJ 07728-1709

Mailing address

55 Stillwell Rd
Kendall Park, NJ 08824-1433
Phone (732) 881-3158

Other identifiers 1

IdentifierTypeStateIssuer
22-3052989OtherNJTAX ID #

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
I20131115000430 NJ Practitioner - Nurse Practitioner 7618103946 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
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)

35 Court St
Suite 1C
Freehold, NJ 07728-1709
Phone (609) 582-4700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00414700NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Side Consulting, LLC Psychiatric/Mental Health CurrentSince Jan 1, 2023 Accepting new patients
NJ Memory and Behavioral Care CurrentSince May 18, 2019 Accepting new patients

Locations

14 Ridgedale Ave
Ste 103
Cedar Knolls, NJ 07927
Phone (973) 295-6335

35 Court St
Ste 1C
Freehold, NJ 07728
Phone (609) 582-4700

Organizations & group practices 2

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": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1013251685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 STILLWELL RD",
            "city": "KENDALL PARK",
            "state": "NJ",
            "postal_code": "088241433",
            "telephone_number": "732-881-3158",
            "fax_number": "279-300-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 COURT ST STE 1C",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077281709",
            "telephone_number": "609-582-4700",
            "fax_number": "279-300-3710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVITT",
        "first_name": "JENNIFER",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-20",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00414700",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00414700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "22-3052989",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

Verify at the official NPI Registry.